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McDonald K, Seltzer E, Lu M, Gaisenband SD, Fletcher C, McLeroth P, Saini KS. Quantifying the impact of the COVID-19 pandemic on clinical trial screening rates over time in 37 countries. Trials 2023; 24:254. [PMID: 37013558 PMCID: PMC10071259 DOI: 10.1186/s13063-023-07277-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
The COVID-19 pandemic has had an unprecedented and disruptive impact on people's health and lives worldwide. In addition to burdening people's health in the short-term in the form of infection, illness, and mortality, there has been an enormous negative impact on clinical research. Clinical trials experienced challenges in ensuring patient safety and enrolling new patients throughout the pandemic. Here, we investigate and quantify the negative impact that the COVID-19 pandemic has industry-sponsored clinical trials, both in the USA and worldwide. We find a negative correlation between the severity of the COVID-19 pandemic and clinical trial screening rate, with the relationship being strongest during the first three months of the pandemic compared to the entire duration of the pandemic. This negative statistical relationship holds across therapeutic areas, across states in the USA despite the heterogeneity of responses at the state-level, and across countries. This work has significant implications for the management of clinical trials worldwide in response to the fluctuating severity of COVID-19 moving forward and for future pandemics.
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Affiliation(s)
- Kelsey McDonald
- Labcorp Drug Development Inc, 206 Carnegie Center Dr, Princeton, NJ, 08540, USA
| | - Earl Seltzer
- Labcorp Drug Development Inc, 206 Carnegie Center Dr, Princeton, NJ, 08540, USA
| | - Mary Lu
- Labcorp Drug Development Inc, 206 Carnegie Center Dr, Princeton, NJ, 08540, USA
| | | | - Cassandra Fletcher
- Labcorp Drug Development Inc, 206 Carnegie Center Dr, Princeton, NJ, 08540, USA
| | - Patrick McLeroth
- Labcorp Drug Development Inc, 206 Carnegie Center Dr, Princeton, NJ, 08540, USA
| | - Kamal S Saini
- Labcorp Drug Development Inc, 206 Carnegie Center Dr, Princeton, NJ, 08540, USA.
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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52
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Malmquist A, Bredenberg C, Melin J, Wurm M, Tasker F, Gato J. Queers in quarantine: Young LGBTQ+ people's experiences during the COVID-19 pandemic in Sweden. Scand J Psychol 2023; 64:150-159. [PMID: 36153699 PMCID: PMC9538029 DOI: 10.1111/sjop.12871] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
Abstract
The COVID-19 pandemic led to major restrictions of everyday life activities. This worsened the social situation of many people, and marginalized groups have been especially affected. This article explores how LGBTQ+ young adults in Sweden have been affected by the COVID-19 pandemic and the subsequent recommendations and restrictions. Fifteen participants between 20-29 years, who self-identified as lesbian, gay, bisexual, transgender, and queer (LGBTQ+), were interviewed about their experiences. A thematic analysis of the data showed that the participants perceived their psychological wellbeing to have been greatly affected by the pandemic. Several reported symptoms of clinical depression, as well as anxiety, worry, rumination, and a heightened sensitivity to stress. Stressors included fear of the disease itself, and fear of spreading the virus, as well as the negative consequences of adhering to the recommendations of social distancing, which constantly interplayed with the marginalized position of being a young LGBTQ+ person. Most participants experienced a decrease in minority stress in face-to-face interaction with social distancing measures in place, but an increase in minority stress online. Those who faced minority stress at home experienced the isolation as particularly stressful. Limited access to the LGBTQ+ community was a common stressor. For transgender participants, the effects on transgender healthcare, such as prolonged waiting times for gender dysphoria assessment and hormone treatment, were a major challenge. Our results have added valuable knowledge to research indicating how vulnerable young adults were highly affected by the COVID-19 pandemic restrictions.
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Affiliation(s)
- Anna Malmquist
- Department of Behavioural Sciences and LearningLinköping UniversityLinköpingSweden
| | - Cecilia Bredenberg
- Department of Behavioural Sciences and LearningLinköping UniversityLinköpingSweden
| | - Jennifer Melin
- Department of Behavioural Sciences and LearningLinköping UniversityLinköpingSweden
| | - Matilda Wurm
- Department of Law, Psychology and Social WorkÖrebro UniversityÖrebroSweden
| | - Fiona Tasker
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Jorge Gato
- Faculty of Psychology and Education SciencesUniversity of PortoPortoPortugal
- Centre for Psychology at the University of PortoPortoPortugal
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Örtqvist AK, Magnus MC, Aabakke AJM, Urhoj SK, Vinkel Hansen A, Nybo Andersen AM, Krebs L, Pettersson K, Håberg SE, Stephansson O. Severe COVID-19 during pregnancy in Sweden, Norway, and Denmark. Acta Obstet Gynecol Scand 2023; 102:681-689. [PMID: 36928990 DOI: 10.1111/aogs.14552] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
INTRODUCTION Pregnancy is a risk factor for severe coronavirus disease 2019 (COVID-19) and adverse pregnancy outcomes. We aimed to explore maternal characteristics, pregnancy outcomes, vaccination status, and virus variants among pregnant women admitted to intensive care units (ICU) with severe COVID-19. MATERIAL AND METHODS We identified pregnant women admitted to ICU in Sweden (n = 96), Norway (n = 31), and Denmark (n = 16) because of severe COVID-19, from national registers and clinical databases between March 2020 and February 2022 (Denmark), August 2022 (Sweden), or December 2022 (Norway). Their background characteristics, pregnancy outcome, and vaccination status were compared with all birthing women and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test-positive pregnant women during the same time period. We calculated the number admitted to ICU per 10 000 birthing and per 1000 SARS-CoV-2 test-positive women during the Index, Alpha, Delta, and Omicron periods. RESULTS Women admitted to ICU had a higher mean body mass index, were more often of non-Scandinavian origin, had on average lower education and income levels, had a higher proportion of chronic and pregnancy-related conditions, delivered preterm, had neonates with low Apgar scores, and had more infants admitted to neonatal care, compared with all birthing and test-positive pregnant women. Of those admitted to ICU, only 7% had been vaccinated before admission. Overall, the highest proportion of women admitted to ICU per birthing was during the Delta period (4.1 per 10 000 birthing women). In Norway, the highest proportion admitted to ICU per test-positive pregnant women was during the Delta period (17.8 per 1000 test-positive), whereas the highest proportion of admitted per test-positive in Sweden and Denmark was seen during the Index period (15.4 and 8.9 per 1000 test-positive, respectively). CONCLUSIONS Admission to ICU because of COVID-19 in pregnancy was a rare event in the Scandinavian countries, but women who were unvaccinated, of non-Scandinavian origin, and with lower socio-economic status were at higher risk of admission to ICU. In addition, women admitted to ICU for COVID-19 had higher risk of adverse pregnancy outcomes.
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Affiliation(s)
- Anne K Örtqvist
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Obstetrics and Gynecology, Visby County Hospital, Visby, Sweden
| | - Maria C Magnus
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anna J M Aabakke
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Holbaek, Holbaek, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital-Northzealand-Hillerød, Hillerød, Denmark
| | - Stine Kjaer Urhoj
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Vinkel Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Statistics Denmark, Copenhagen, Denmark
| | | | - Lone Krebs
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
| | - Karin Pettersson
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Division of Women's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Siri E Håberg
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Division of Women's Health, Karolinska University Hospital, Stockholm, Sweden
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Antai I, Hellberg R. Identifying total defense logistics concepts: a comparative study of the Swedish pandemic response. JOURNAL OF HUMANITARIAN LOGISTICS AND SUPPLY CHAIN MANAGEMENT 2023. [DOI: 10.1108/jhlscm-07-2022-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Purpose
The total defence (TD) concept constitutes a joint endeavour between the military forces and civil defence structures within a TD state. Logistics is essential for such joint collaboration to work; however, the mismatch between military and civil defence logistics structures poses challenges for such joint collaboration. The purpose of this paper is to identify logistics concept areas within the TD framework that allow for military and civil defence collaborations from a logistics operations perspective.
Design/methodology/approach
Pattern-matching analysis is used to compare patterns found in the investigated case with those prescribed from the literature and predicted to occur. The study seeks to identify logistics concepts within TD from the literature and from the events describing the Swedish response to the Covid-19 pandemic. Pattern matching thus allows for the reconciliation of logistics concepts from the literature to descriptions of how the response was handled, albeit under a TD framework.
Findings
Findings show quite distinct foci between the theoretical and observational realms in terms of logistics applications. While the theoretical realm identifies four main logistics concepts, the observational realm identifies five logistics conceptual themes. This goes on to show an incongruence between the military and civil parts of the TD.
Research limitations/implications
This study provides basis for further research into the applications and management of logistics activity within TD and emergency response.
Originality/value
Logistics applications within TD have not, until now, received much attention in the literature. Given this knowledge gap, this study is of original value.
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Miregård J, Nowicka P, Nylander C. National data showed an increased prevalence of overweight and obesity among four-year-old Swedish children during the first year of COVID-19. Acta Paediatr 2023; 112:1269-1274. [PMID: 36872489 DOI: 10.1111/apa.16707] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 03/07/2023]
Abstract
AIM This paper summarised national data on the prevalence of overweight and obesity among 4-year-old children in Sweden in 2020, the first year of the COVID-19 pandemic. It compares this with data from 2018. Differences between regions and sex were identified. METHODS Comparative data from Swedish Child Health Services were available for 18/21 regions. Chi-square tests were used to compare data from 2018 and 2020 and to examine differences between the sexes. Sex and year were examined through interaction tests. RESULTS In 2020, 13.3% of the 100 001 children had overweight or obesity: 15.1% of the girls and 11.6% of the boys (p < 0.001). In 2018, 11.4% of the 105 445 children had overweight or obesity: 13.2% of the girls and 9.4% of the boys. This was an overall increase of 16.6% (p = 0.000) in the national Swedish data from 2018 to 2020. The increase between the years was greater for obesity (31.8%, p = 0.000) than for overweight (13.3%, p = 0.000). CONCLUSION The prevalence of overweight and obesity among 4-year-olds in Sweden increased during the COVID-19 pandemic and needs to be addressed. The prevalence needs to be followed as part of prevention programmes and to evaluate health interventions.
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Affiliation(s)
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Solna, Sweden.,Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Charlotte Nylander
- Child Health Services Sörmland, Eskilstuna, Sweden.,Centre for Clinical Research Sörmland, Eskilstuna, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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56
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Beirakdar S, Klingborg L, Herzig van Wees S. Attitudes of Swedish Language Twitter Users Toward COVID-19 Vaccination: Exploratory Qualitative Study. JMIR INFODEMIOLOGY 2023; 3:e42357. [PMID: 37012999 PMCID: PMC9996415 DOI: 10.2196/42357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/05/2022] [Accepted: 01/10/2023] [Indexed: 02/24/2023]
Abstract
Background
Social media have played an important role in shaping COVID-19 vaccine choices during the pandemic. Understanding people’s attitudes toward the vaccine as expressed on social media can help address the concerns of vaccine-hesitant individuals.
Objective
The aim of this study was to understand the attitudes of Swedish-speaking Twitter users toward COVID-19 vaccines.
Methods
This was an exploratory qualitative study that used a social media–listening approach. Between January and March 2022, a total of 2877 publicly available tweets in Swedish were systematically extracted from Twitter. A deductive thematic analysis was conducted using the World Health Organization’s 3C model (confidence, complacency, and convenience).
Results
Confidence in the safety and effectiveness of the COVID-19 vaccine appeared to be a major concern expressed on Twitter. Unclear governmental strategies in managing the pandemic in Sweden and the belief in conspiracy theories have further influenced negative attitudes toward vaccines. Complacency—the perceived risk of COVID-19 was low and booster vaccination was unnecessary; many expressed trust in natural immunity. Convenience—in terms of accessing the right information and the vaccine—highlighted a knowledge gap about the benefits and necessity of the vaccine, as well as complaints about the quality of vaccination services.
Conclusions
Swedish-speaking Twitter users in this study had negative attitudes toward COVID-19 vaccines, particularly booster vaccines. We identified attitudes toward vaccines and misinformation, indicating that social media monitoring can help policy makers respond by developing proactive health communication interventions.
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Affiliation(s)
- Safwat Beirakdar
- Karolinska Institute Department of Global Public Health Stockholm Sweden
| | - Leon Klingborg
- Karolinska Institute Department of Global Public Health Stockholm Sweden
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Tiger M, Wesselhoeft R, Karlsson P, Handal M, Bliddal M, Cesta CE, Skurtveit S, Reutfors J. Utilization of antidepressants, anxiolytics, and hypnotics during the COVID-19 pandemic in Scandinavia. J Affect Disord 2023; 323:292-298. [PMID: 36442654 PMCID: PMC9691511 DOI: 10.1016/j.jad.2022.11.068] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study patterns of antidepressant, anxiolytic, and hypnotic drug utilization in Denmark, Norway, and Sweden during the first year of the COVID-19 pandemic. METHODS The monthly observed number of prescription fills of antidepressants, benzodiazepines and benzodiazepine-related hypnotics (BZ), and other anxiolytics and hypnotics (OAH) per population in 2020 were compared with predicted numbers based on analysis of covariance of prescription fills during 2015-2019. RESULTS In March 2020, there was an increased number of prescription fills for antidepressants, anxiolytics, and hypnotics in youths and adults aged 20-59 years in Denmark, Norway, and Sweden. Antidepressant prescription fills increased between 13.5 % and 31.3 % at the end of 2020 in all age groups in Denmark and 17.4 % in youths in Norway. BZ drug prescription fills increased by 20.8 % at the end of 2020 in the 20-59 year age group in Denmark and decreased by 16.7 % in youths in Sweden. A general increase of prescription fills of OAH at the end of 2020 was observed in all countries (range 24.0-80.0 % in Denmark, 11.5-30.8 % in Norway, and 9.1-12.1 % in Sweden). Increases of prescription fills of OAH occurred earlier in Denmark. LIMITATIONS Aggregated data with lack of information on indications. CONCLUSIONS Peaks of utilization of antidepressants, anxiolytics, and hypnotics observed in March 2020 may reflect medication stock piling. Increased antidepressant drug utilization in Denmark and in Norwegian youths together with the general increase in OAH utilization in the Scandinavian countries in late 2020 may indicate an increase of symptoms of depression and anxiety, as well as disturbed sleep.
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Affiliation(s)
- Mikael Tiger
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden.
| | - Rikke Wesselhoeft
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark
| | - Pär Karlsson
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Marte Handal
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mette Bliddal
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Carolyn E Cesta
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Svetlana Skurtveit
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johan Reutfors
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
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Sarkadi A, Thell M, Jirblom K. Perceptions of the COVID-19 pandemic as demonstrated in drawings of Swedish children aged 4-6 years. Acta Paediatr 2023; 112:1275-1283. [PMID: 36773326 DOI: 10.1111/apa.16706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
AIM To explore the perceptions of the COVID-19 pandemic, as expressed in the drawings of Swedish children aged 4-6 years. METHODS We analysed 91 drawings with associated descriptions submitted to the Swedish Archive of Children's Art from April 2020 to February 2021. RESULTS The visual and text analysis resulted in three themes. First, illustrating the virus and embodying the danger showed that young children understood the invisible enemy, combining realistic elements of the virus particle with fantasies of the 'virus monster' that needs to be fought off. Second, life has changed for the worse describes the profound effect the pandemic had on young children's lives also in Sweden, with comparatively mild restrictions and no school closures. Third, the virus spreads across the world, affects people and infects their bodies conveys young children's understanding of the pandemic as an existential challenge affecting the whole world. Children displayed surprisingly high levels of health literacy related to COVID-19, including contagion routes and the importance of hand hygiene. CONCLUSION The drawings of Swedish children aged 4-6 years demonstrated the profound, practical and emotional effects of the pandemic on their lives. Drawings also illuminated young children's level of health literacy regarding COVID-19.
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Affiliation(s)
- Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Thell
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Klara Jirblom
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Wathore R, Rawlekar S, Anjum S, Gupta A, Bherwani H, Labhasetwar N, Kumar R. Improving performance of deep learning predictive models for COVID-19 by incorporating environmental parameters. GONDWANA RESEARCH : INTERNATIONAL GEOSCIENCE JOURNAL 2023; 114:69-77. [PMID: 35431596 PMCID: PMC8990533 DOI: 10.1016/j.gr.2022.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 05/15/2023]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has severely crippled the economy on a global scale. Effective and accurate forecasting models are essential for proper management and preparedness of the healthcare system and resources, eventually aiding in preventing the rapid spread of the disease. With the intention to provide better forecasting tools for the management of the pandemic, the current research work analyzes the effect of the inclusion of environmental parameters in the forecasting of daily COVID-19 cases. Three univariate variants of the long short-term memory (LSTM) model (basic/vanilla, stacked, and bi-directional) were employed for the prediction of daily cases in 9 cities across 3 countries with varying climatic zones (tropical, sub-tropical, and frigid), namely India (New Delhi and Nagpur), USA (Yuma and Los Angeles) and Sweden (Stockholm, Skane, Uppsala and Vastra Gotaland). The results were compared to a basic multivariate LSTM model with environmental parameters (temperature (T) and relative humidity (RH)) as additional inputs. Periods with no or minimal lockdown were chosen specifically in these cities to observe the uninhibited spread of COVID-19 and explore its dependence on daily environmental parameters. The multivariate LSTM model showed the best overall performance; the mean absolute percentage error (MAPE) showed an average of 64% improvement from other univariate models upon the inclusion of the above environmental parameters. Correlation with temperature was generally positive for the cold regions and negative for the warm regions. RH showed mixed correlations, most likely driven by its temperature dependence and effect of allied local factors. The results suggest that the inclusion of environmental parameters could significantly improve the performance of LSTMs for predicting daily cases of COVID-19, although other positive and negative confounding factors can affect the forecasting power.
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Affiliation(s)
- Roshan Wathore
- CSIR-National Environmental Engineering Research Institute (CSIR-NEERI), Nehru Marg, Nagpur 440020, Maharashtra, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Samyak Rawlekar
- Indian Institute of Technology (IIT) Dharwad, Dharwad 580 011, Karnataka, India
| | - Saima Anjum
- CSIR-National Environmental Engineering Research Institute (CSIR-NEERI), Nehru Marg, Nagpur 440020, Maharashtra, India
| | - Ankit Gupta
- CSIR-National Environmental Engineering Research Institute (CSIR-NEERI), Nehru Marg, Nagpur 440020, Maharashtra, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Hemant Bherwani
- CSIR-National Environmental Engineering Research Institute (CSIR-NEERI), Nehru Marg, Nagpur 440020, Maharashtra, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Nitin Labhasetwar
- CSIR-National Environmental Engineering Research Institute (CSIR-NEERI), Nehru Marg, Nagpur 440020, Maharashtra, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Rakesh Kumar
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
- Council of Scientific and Industrial Research (CSIR), Anusandhan Bhawan, 2 Rafi Ahmed Kidwai Marg, New Delhi 110001, India
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Mattsson E, Lindblad M, Kneck Å, Salzmann-Eriksson M, Klarare A. Voices of women in homelessness during the outbreak of the COVID-19 pandemic: a co-created qualitative study. BMC Womens Health 2023; 23:11. [PMID: 36627642 PMCID: PMC9830620 DOI: 10.1186/s12905-023-02157-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Women in homelessness face extreme health- and social inequities. It could be postulated that during societal crises, they become even more vulnerable. Thus, the aim was to explore experiences related to the COVID-19 pandemic among women in homelessness. METHODS Ten interviews were conducted with women in homelessness, in Stockholm, Sweden, using researcher-driven photo elicitation. The data analysis was guided by the DEPICT model for collaborative data analysis and a qualitative content analysis was performed. A collaborative reference group of women with lived experience of homelessness contributed to the research process through designing the data collection, performing the data analysis, and providing feedback during report writing. RESULTS For women in homelessness, the COVID-19 pandemic was adding insult to injury, as it significantly affected everyday life and permeated most aspects of existence, leading to diminished interactions with others and reduced societal support. Thus, in an already dire situation, the virus amplified health- and social issues to another level. The women strived to find their balance on the shifting sands of guidelines and restrictions due to the pandemic. Adhering to the new social distancing rules and guidelines in line with the rest of society, was simply impossible when experiencing homelessness. However, for some women the pandemic was nothing but a storm in a teacup. The harsh reality continued irrespectively, living one day at a time and prioritizing provision for basic human needs. CONCLUSIONS The COVID-19 pandemic and homelessness can be viewed as two intersecting crises. However, the women's aggregated experiences were greater than the sum of experiencing homelessness and meeting the threat of the virus. Gender, exposure to violence, poverty, social isolation, and substance use were additional factors that further marginalized the women during the pandemic. To rebuild a better and more sustainable post-pandemic future for all, global commitment to ending homelessness is crucial. In addition, addressing social determinants of health must be the number one health intervention.
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Affiliation(s)
- Elisabet Mattsson
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, 751 85 Uppsala, Sweden ,grid.412175.40000 0000 9487 9343Department of Health Care Sciences, Marie Cederschiöld University, Stigbergsgatan 30, Box 11189, 100 61 Stockholm, Sweden
| | - Marléne Lindblad
- Department of Health Sciences, Swedish Red Cross University, Box 1059, 141 21 Huddinge, Sweden
| | - Åsa Kneck
- grid.412175.40000 0000 9487 9343Department of Health Care Sciences, Marie Cederschiöld University, Stigbergsgatan 30, Box 11189, 100 61 Stockholm, Sweden
| | - Martin Salzmann-Eriksson
- grid.69292.360000 0001 1017 0589Department of Caring Sciences, Faculty of Health an Occupational Studies, University of Gävle, 801 76 Gävle, Sweden
| | - Anna Klarare
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, 751 85 Uppsala, Sweden ,grid.412175.40000 0000 9487 9343Department of Health Care Sciences, Marie Cederschiöld University, Stigbergsgatan 30, Box 11189, 100 61 Stockholm, Sweden
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Secnik J, Eriksdotter M, Xu H, Annetorp M, Rytarowski A, Johnell K, Hägg S, Religa D. Dementia and psychotropic medications are associated with significantly higher mortality in geriatric patients hospitalized with COVID-19: data from the StockholmGeroCovid project. Alzheimers Res Ther 2023; 15:5. [PMID: 36609457 PMCID: PMC9817345 DOI: 10.1186/s13195-022-01154-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/25/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Dementia and psychotropic medications are discussed as risk factors for severe/lethal outcome of the coronavirus disease 2019 (COVID-19). We aimed to explore the associations between the presence of dementia and medication use with mortality in the hospitalized and discharged patients who suffered from COVID-19. METHODS We conducted an open-cohort observational study based on electronic patient records from nine geriatric care clinics in the larger Stockholm area, Sweden, between February 28, 2020, and November 22, 2021. In total, we identified 5122 hospitalized patients diagnosed with COVID-19, out of which 762 (14.9%) patients had concurrent dementia and 4360 (85.1%) were dementia-free. Patients' age, sex, baseline oxygen saturation, comorbidities, and medication prescription (cardiovascular and psychotropic medication) were registered at admission. The hazard ratios (HRs) with 95% confidence intervals (CIs) of in-hospital, 30-day, 90-day, 365-day post-discharge, and overall mortality during the follow-up were obtained. Then, the associations of dementia and medication use with mortality were determined using proportional hazards regression with time since entry as a time scale. RESULTS After adjustment, dementia was independently associated with 68% higher in-hospital mortality among COVID-19 patients compared to patients who were dementia-free at admission [HRs (95% CI) 1.68 (1.37-2.06)]. The increase was consistent post-discharge, and the overall mortality of dementia patients was increased by 59% [1.59 (1.40-1.81)]. In addition, the prescription of antipsychotic medication at hospital admission was associated with a 70% higher total mortality risk [1.70 (1.47-1.97)]. CONCLUSIONS The clinical co-occurence of dementia and COVID-19 increases the short- and long-term risk of death, and the antipsychotics seem to further the risk increase. Our results may help identify high-risk patients in need of more specialized care when infected with COVID-19.
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Affiliation(s)
- Juraj Secnik
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Neo, Blickagången 16, 14152, Huddinge, Sweden.
- Department of Neurology, Charles University, Second Faculty of Medicine, Motol University Hospital, Prague, Czech Republic.
| | - Maria Eriksdotter
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Neo, Blickagången 16, 14152, Huddinge, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Hong Xu
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Neo, Blickagången 16, 14152, Huddinge, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Martin Annetorp
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Neo, Blickagången 16, 14152, Huddinge, Sweden
| | - Aleksander Rytarowski
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Neo, Blickagången 16, 14152, Huddinge, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sara Hägg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Dorota Religa
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Neo, Blickagången 16, 14152, Huddinge, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
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van Vuuren A. Is there a diminishing willingness to pay for consumption amenities as a result of the Covid-19 pandemic? REGIONAL SCIENCE AND URBAN ECONOMICS 2023; 98:103858. [PMID: 36570978 PMCID: PMC9758510 DOI: 10.1016/j.regsciurbeco.2022.103858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
We employ the Covid-19 pandemic as an unanticipated event in order to investigate the willingness to pay for consumption amenities such as restaurants, cinemas and theaters. We use a hedonic pricing model in combination with a time-gradient difference-in-difference approach. Our data set contains virtually all apartments for sale in the larger Stockholm area. We use a very detailed and flexible definition of the density of consumption amenities based on the exact location of these amenities and the walking distance from the apartments to these amenities. Although there are differences between specifications, we find a decrease of 3.9 percent of apartments that we label as amenity rich. Based on the average apartment price, this equals a drop of 195,240 Swedish Kronor (or almost 22,000 US dollars).
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Affiliation(s)
- Aico van Vuuren
- Gothenburg University, Sweden
- University of Groningen, The Netherlands
- IZA, Germany
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Clinical characteristics and factors associated with ICU mortality during the first year of the SARS-Cov-2 pandemic in Romania: A prospective, cohort, multicentre study of 9000 patients. Eur J Anaesthesiol 2023; 40:4-12. [PMID: 36385096 DOI: 10.1097/eja.0000000000001776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The epidemiology of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be different worldwide. Despite similarities in medicine quality and formation, there are also significant differences concerning healthcare and ICU organisation, staffing, financial resources and population compliance and adherence. Large cohort data of critically ill patients from Central and Eastern Europe are also lacking. OBJECTIVES The study objectives were to describe the clinical characteristics of patients admitted to Romanian ICUs with SARS-CoV-2 infection and to identify the factors associated with ICU mortality. DESIGN Prospective, cohort, observational study. SETTING National recruitment, multicentre study, between March 2020 to March 2021. PATIENTS All patients with SARS-CoV-2 infection admitted to Romanian ICUs were eligible. There were no exclusion criteria. INTERVENTION None. MAIN OUTCOME MEASURE ICU mortality. RESULTS The statistical analysis included 9058 patients with definitive ICU outcome. The multivariable mixed effects logistic regression model found that age [odds ratio (OR) 1.27; 95% confidence interval (CI), 1.23 to 1.31], male gender (OR 1.21; 95% CI 1.05 to 1.4), medical history of neoplasia (OR 1.74; 95% CI, 1.36 to 2.22), chronic kidney disease (OR 1.54; 95% CI, 1.27 to 1.88), type II diabetes (OR 1.23; 95% CI, 1.06 to 1.43), chronic heart failure (OR 1.24; 95% CI, 1.03 to 1.49), dyspnoea (OR 1.3; 95% CI, 1.1 to 1.5), SpO2 less than 90% (OR 3; 95% CI, 2.5 to 3.5), admission SOFA score (OR 1.07; 95% CI, 1.05 to 1.09), acute respiratory distress syndrome (ARDS) on ICU admission (OR 1.35; 95% CI, 1.1 to 1.63) and the need for noninvasive (OR 1.8, 95% CI, 1.5 to 1.22) or invasive ventilation (OR 28; 95% CI, 22 to 35) and neuromuscular blockade (OR 3.5; 95% CI, 2.6 to 4.8), were associated with larger ICU mortality.Higher GCS on admission (OR 0.81; 95% CI, 0.79 to 0.83), treatment with hydroxychloroquine (OR 0.78; 95% CI, 0.64 to 0.95) and tocilizumab (OR 0.58; 95% CI, 0.48 to 0.71) were inversely associated with ICU mortality. CONCLUSION The SARS-CoV-2 critically ill Romanian patients share common personal and clinical characteristics with published European cohorts. Public health measures and vaccination campaign should focus on patients at risk.
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Termorshuizen JD, Sun Q, Borg S, Mantilla EF, Goode RW, Peat CM, Thornton LM, Watson H, van Furth EF, Birgegård A, Bulik CM. Longer-term impact of COVID-19 among individuals with self-reported eating disorders in the United States, the Netherlands, and Sweden. Int J Eat Disord 2023; 56:80-90. [PMID: 36237128 PMCID: PMC9851943 DOI: 10.1002/eat.23824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE We assessed eating disorder (ED) illness status, symptomatology, treatment access, anxiety, and depression in the first year of the COVID-19 pandemic among individuals with a pre-existing ED in the United States (US), the Netherlands (NL), and Sweden (SE). METHODS Participants completed online surveys in April-July 2020, at the early stage of the pandemic, and one year later. At one-year follow-up, we added questions addressing retrospective changes in ED symptoms, treatment, and anxiety/depression since the start of the COVID-19 pandemic. We present descriptive statistics and assess change in ED symptomatology, treatment, and anxiety/depression among those with an active or lingering ED. RESULTS Participants (US n = 132; NL n = 219; SE n = 702) were mostly young and female with a history of anorexia nervosa (>60% in all three countries). Across countries, respondents reported impact of COVID-19 on ED symptoms at both time points, with improvement in US and NL at one-year follow-up, and stable but less impact on ED symptoms in SE. Furthermore, at one-year follow-up, roughly half of those in treatment reported reduced treatment access and quality, and the majority of the sample reported increased anxiety and depressive mood since the start of the pandemic. DISCUSSION Our findings suggest that the self-perceived impact of COVID-19 changed over time but remained concerning even one year after the start of the pandemic. Clinicians, community organizations, and policy makers are encouraged to address potentially changing treatment needs in the face of public health emergency events. PUBLIC SIGNIFICANCE Our findings suggest that the impact of COVID-19 on individuals with eating disorders decreased over time but remained concerning even one year after the start of the pandemic and that the impact differed across countries. Clinicians, community organizations, and policy makers are encouraged to incorporate this knowledge to address potentially changing treatment needs in the face of public health emergency events.
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Affiliation(s)
- Jet D. Termorshuizen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- GGZ Rivierduinen Eating Disorders UrsulaLeidenSouth HollandThe Netherlands
| | - Quan Sun
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Stina Borg
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Emma F. Mantilla
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Rachel W. Goode
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Discipline of Psychology, School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Eric F. van Furth
- GGZ Rivierduinen Eating Disorders UrsulaLeidenSouth HollandThe Netherlands
- Department of PsychiatryLeiden University Medical CenterLeidenSouth HollandThe Netherlands
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Thompson KA, Hedlund EL, Sun Q, Peat CM, Goode RW, Termorshuizen JD, Thornton LM, Borg S, van Furth EF, Birgegård A, Bulik CM, Watson HJ. Course and predictors of eating disorder symptoms, anxiety symptoms, and pandemic-related eating disorder concerns among adults with eating disorders during the first year of the COVID-19 pandemic. Int J Eat Disord 2023; 56:151-168. [PMID: 36508290 PMCID: PMC9877876 DOI: 10.1002/eat.23870] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The COVID-19 pandemic and public health mitigation measures have negatively impacted individuals with eating disorders (ED). We evaluated changes in and predictors of ED symptoms, pandemic-related ED concerns, and anxiety symptoms across the first 12 months of the COVID-19 pandemic among individuals with self-reported EDs in the United States (US), Sweden (SE), and the Netherlands (NL). METHOD Participants in the US (N = 510), SE (N = 982), and NL (N = 510) completed an online survey assessing ED symptoms (binge eating, restriction, compensatory behaviors, and anxiety about being unable to exercise), general anxiety symptoms, and pandemic-related ED concerns about accessing food, lack of structure and social support, being in a triggering environment, and food and treatment costs. In the US and NL, respondents completed surveys beginning April 2020 and continuing monthly for a year. In SE, respondents completed baseline surveys in May 2020, a six-month follow-up around December 2020, and a 12-month follow-up in May 2021. RESULTS Three patterns emerged: (1) a curvilinear course with the highest level of symptoms at baseline, declining through November 2020, and increasing through the rest of the year; (2) a linear declining course over time; and (3) a stable course with no changes. Worries about COVID-19 infection, lockdown, concerns about lack of structure and social support, and concerns about accessing food consistent with one's recovery meal plan predicted increases in ED symptoms. DISCUSSION ED symptoms tracked with pandemic-related concerns in people with EDs. Conceptualizing predictors of symptoms may inform therapy and public health resources that reduce the impact of pandemics on mental health. PUBLIC SIGNIFICANCE Our findings suggest that the COVID-19 pandemic had negative impacts on people with eating disorders, including amplification of mental health symptoms and stressors around peak periods of infection and COVID-19 restrictions. These findings inform medical providers, policy-makers, and community-based supports about the information and resource needs of this group to ensure efficient dissemination in future public health emergencies and during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Katherine A. Thompson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Elin L. Hedlund
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Quan Sun
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Rachel W. Goode
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jet D. Termorshuizen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Rivierduinen Eating Disorders UrsulaLeidenthe Netherlands
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Stina Borg
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Eric F. van Furth
- Rivierduinen Eating Disorders UrsulaLeidenthe Netherlands,Department of PsychiatryLeiden University Medical CenterLeidenthe Netherlands
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna J. Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Discipline of Psychology, School of Population HealthCurtin UniversityPerthAustralia,Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthAustralia
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Lan Y, Yin L, Wang X. Dynamics of COVID-19 progression and the long-term influences of measures on pandemic outcomes. Emerg Themes Epidemiol 2022; 19:10. [PMID: 36550573 PMCID: PMC9773575 DOI: 10.1186/s12982-022-00119-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
The pandemic progression is a dynamic process, in which measures yield outcomes, and outcomes in turn influence subsequent measures and outcomes. Due to the dynamics of pandemic progression, it is challenging to analyse the long-term influence of an individual measure in the sequence on pandemic outcomes. To demonstrate the problem and find solutions, in this article, we study the first wave of the pandemic-probably the most dynamic period-in the Nordic countries and analyse the influences of the Swedish measures relative to the measures adopted by its neighbouring countries on COVID-19 mortality, general mortality, COVID-19 incidence, and unemployment. The design is a longitudinal observational study. The linear regressions based on the Poisson distribution or the binomial distribution are employed for the analysis. To show that analysis can be timely conducted, we use table data available during the first wave. We found that the early Swedish measure had a long-term and significant causal effect on public health outcomes and a certain degree of long-term mitigating causal effect on unemployment during the first wave, where the effect was measured by an increase of these outcomes under the Swedish measures relative to the measures adopted by the other Nordic countries. This information from the first wave has not been provided by available analyses but could have played an important role in combating the second wave. In conclusion, analysis based on table data may provide timely information about the dynamic progression of a pandemic and the long-term influence of an individual measure in the sequence on pandemic outcomes.
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Affiliation(s)
- Yihong Lan
- Suntar Research Institute, Singapore, Singapore
| | - Li Yin
- grid.465198.7Karolinska Institutet, Solna, Sweden
| | - Xiaoqin Wang
- grid.69292.360000 0001 1017 0589University of Gävle, Gävle, Sweden
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Health Consequences of the COVID-19 Pandemic among Health-Care Workers: A Comparison between Groups Involved and Not Involved in COVID-19 Care. Healthcare (Basel) 2022; 10:healthcare10122540. [PMID: 36554064 PMCID: PMC9778037 DOI: 10.3390/healthcare10122540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Health consequences have been reported among health-care workers (HCWs) exposed to COVID-19. Sweden chose to manage the pandemic with a lower and more equal long-lasting work strain and shorter periods of recovery than in other countries. Few studies have examined the health consequences among HCWs working in such conditions. This study compared the health consequences after the first wave of the COVID-19 pandemic between HCWs involved in the care of COVID-19 patients and other HCWs and between occupational groups working in COVID-19 care. Multinomial logistic regression and univariate general linear models were used to identify differences. The levels of depression, emotional and physical fatigue, sleep quality, and general health were measured 6 months after the onset of the pandemic in 3495 HCW employed in Sweden. HCWs directly involved in COVID-19 care reported significantly poorer sleep quality and higher scores on emotional and physical exhaustion than those not involved in such care. Health consequences did not differ significantly between different occupational groups involved in COVID-19 care except for specialist nurses/midwives. HCWs more frequently involved in COVID-19 care reported higher levels of emotional and physical fatigue and poorer sleep but less severe than those reported in more severely affected countries.
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Hedman C, Fürst CJ, Rasmussen BH, van der Heide A, Schelin MEC. Dying during the COVID-19 Pandemic in Sweden: Relatives' Experiences of End-of-Life Care (the CO-LIVE Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16146. [PMID: 36498221 PMCID: PMC9740982 DOI: 10.3390/ijerph192316146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Background: The COVID-19 pandemic has seen many deaths, but the majority were for causes other than COVID-19. However, end-of-life care in all settings has been affected by measures limiting the spread of the virus, for patients with and without COVID-19. The Swedish coronavirus strategy was different compared to many other countries, which might have affected end-of-life care. The aim was to describe the experiences of end-of-life care for bereaved relatives in Sweden during the “first wave” and to compare the experiences for deaths due to COVID-19 with the experiences for deaths for other reasons. Methods: A random sample of addresses for 2400 people who died during March−September 2020 was retrieved from the Swedish Person Address Registry. Relatives were contacted with a questionnaire regarding their experience of end-of-life care, with a focus on communication, participation, and trust. Results: In total, 587 relatives (25% response rate) answered the questionnaire (14% COVID-19-deaths, 65% non-COVID-19-deaths, 21% uncertain). In the COVID-19 group 28% of the relatives were allowed visits without restrictions compared to 60% in the non-COVID-19 group (p < 0.01). Only 28% of the relatives in the COVID-19 group reported that the person received “enough care from physicians”, significantly fewer than the non-COVID group (65%, p < 0.01). Conclusion: Relatives’ experience of end-of-life care for persons with COVID-19 was significantly worse than relatives of persons without COVID-19, but relatives for persons without COVID-19 were also negatively affected.
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Affiliation(s)
- Christel Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Anna Steckséns gata 53, SE-17176 Stockholm, Sweden
- R&D Department, Stockholms Sjukhem Foundation, Mariebergsgatan 22, SE-11219 Stockholm, Sweden
- Department of Clinical Sciences Lund, Lund University, BMC, Sölvegatan 19, SE-22362 Lund, Sweden
- Institute for Palliative Care, Lund University and Region Skåne, Scheelevägen 2, Medicon Village, SE-22381 Lund, Sweden
| | - Carl Johan Fürst
- Department of Clinical Sciences Lund, Lund University, BMC, Sölvegatan 19, SE-22362 Lund, Sweden
- Institute for Palliative Care, Lund University and Region Skåne, Scheelevägen 2, Medicon Village, SE-22381 Lund, Sweden
| | - Birgit H. Rasmussen
- Institute for Palliative Care, Lund University and Region Skåne, Scheelevägen 2, Medicon Village, SE-22381 Lund, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1B, SE-22240 Lund, Sweden
| | - Agnes van der Heide
- Institute for Palliative Care, Lund University and Region Skåne, Scheelevägen 2, Medicon Village, SE-22381 Lund, Sweden
- Department of Public Health, Erasmus MC, Dr. Molewaterplein 40, NL-3015 GD Rotterdam, The Netherlands
| | - Maria E. C. Schelin
- Department of Clinical Sciences Lund, Lund University, BMC, Sölvegatan 19, SE-22362 Lund, Sweden
- Institute for Palliative Care, Lund University and Region Skåne, Scheelevägen 2, Medicon Village, SE-22381 Lund, Sweden
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Gustafsson PE, Fonseca-Rodríguez O, Nilsson I, San Sebastián M. Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting. Soc Sci Med 2022; 314:115447. [PMID: 36288648 PMCID: PMC9556960 DOI: 10.1016/j.socscimed.2022.115447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 01/26/2023]
Abstract
Loneliness among older adults is a public health problem that has received particular attention since the emergence of the COVID-19 pandemic. Studies to date have however found a rather modest psychosocial impact of the pandemic on older adults, and scarce research has analyzed this impact using a comprehensive equity lens. The present study used an intersectional approach to examine social inequalities in loneliness before and during the early phase of the pandemic among older adults receiving eldercare in Sweden. The study population (analytical N = 205,529) came from two waves (2019 and 2020) of a total population survey to all older adult (>65 years of age) home care recipients and nursing home residents in Sweden. Loneliness was self-reported by a single-item measure, and survey data were linked to population register data on age, gender, residential setting, income, and country of birth. Additive binomial regression models were used to estimate prevalence differences and discriminatory accuracy according to an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach. Results showed inequalities in loneliness arising particularly in the intersection of country of birth, income, and residential setting. The inequalities widened slightly but ubiquitously following the emergence of the pandemic in 2020, with particularly nursing home residents emerging as a risk group. The discriminatory accuracy of inequalities was consistently low to moderate throughout the analyses but increased marginally during the pandemic in 2020. The study illustrates how social inequalities engenders heterogeneity in the psychosocial risk of older adults before and during the pandemic. These findings should stimulate more nuanced and equity-oriented depictions, research and policies about loneliness among older adults in the peri-pandemic era.
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Affiliation(s)
- Per E. Gustafsson
- Department of Epidemiology and Global Health, Umeå University, 901 87, Sweden,Corresponding author
| | | | - Ingeborg Nilsson
- Department of Community Medicine and Rehabilitation, Unit of Occupational Therapy, Umeå University, 901 87, Sweden
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Magnus MC, Oakley LL, Hansen AV, Örtqvist AK, Petersen TG, Mortensen LH, Bliddal M, Andersen AMN, Stephansson O, Håberg SE. Fetal death after the introduction of COVID-19 mitigation measures in Sweden, Denmark and Norway: a registry-based study. Sci Rep 2022; 12:20625. [PMID: 36450919 PMCID: PMC9709372 DOI: 10.1038/s41598-022-25036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
It remains unclear whether the rate of fetal death has changed during the COVID-19 pandemic. We assessed the impact of COVID-19 mitigation measures on fetal death in Sweden (449,347 births), Denmark (290,857 pregnancies) and Norway (261,057 pregnancies) using robust population-based registry data. We used Cox regression to assess the impact of the implementation of pandemic mitigation measures on March 12th, 2020, on miscarriage (fetal loss before gestational week 22) and stillbirth (fetal loss after gestational week 22). A total of 11% of 551,914 pregnancies in Denmark and Norway ended in miscarriage, while the proportion of stillbirths among 937,174 births across the three countries was 0.3%. There was no difference in the risk of fetal death during the year following pandemic mitigation measures. For miscarriage, the combined hazard ratio (HR) for Norway and Denmark was 1.01 (95% CI 0.98, 1.03), and for stillbirth, the combined HR for all three countries was 0.99 (95% CI 0.89, 1.09). We observed a slightly decreased risk of miscarriage during the first 4 months, with an HR of 0.94 (95% CI 0.90, 0.99) after lockdown. In conclusion, the risk of fetal death did not change after the implementation of COVID-19 pandemic mitigation measures in the three Scandinavian countries.
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Affiliation(s)
- Maria C. Magnus
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway
| | - Laura L. Oakley
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway ,grid.8991.90000 0004 0425 469XDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne V. Hansen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark ,grid.437930.a0000 0001 2248 6353Statistics Denmark, Copenhagen, Denmark
| | - Anne K. Örtqvist
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden ,Department of Obstetrics and Gynaecology, Visby County Hospital, Visby, Sweden
| | - Tanja G. Petersen
- grid.7143.10000 0004 0512 5013Open, Odense University Hospital, Odense, Denmark
| | - Laust H. Mortensen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark ,grid.437930.a0000 0001 2248 6353Statistics Denmark, Copenhagen, Denmark
| | - Mette Bliddal
- grid.10825.3e0000 0001 0728 0170OPEN, University of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anne-Marie Nybo Andersen
- grid.5254.60000 0001 0674 042XDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Olof Stephansson
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Women’s Health, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Siri E. Håberg
- grid.418193.60000 0001 1541 4204Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway
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71
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Donaghy B, Walker SC, Moore DJ. Social distancing with chronic pain during COVID-19: A cross-sectional correlational analysis. PLoS One 2022; 17:e0275680. [PMID: 36409671 PMCID: PMC9678271 DOI: 10.1371/journal.pone.0275680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/21/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Understanding of the role social factors play in chronic pain is growing, with more adaptive and satisfying social relationships helping pain management. During the COVID-19 pandemic, social distancing measures facilitated a naturalistic study of how changes to social interaction affected chronic pain intensity. METHODS In a cross-sectional correlational design, questionnaire data was collected over a 38-day period during the March 2020 COVID-19 lockdown, individuals with chronic pain were asked about their current pain experience as well as notable social factors which might relate to pain. RESULTS Multiple regression analysis revealed social satisfaction significantly predicted pain experience, with a reduction in social participation during COVID-19 lockdowns increasing pain disability, and increased social satisfaction associated with decreasing pain intensity. CONCLUSIONS While pain management often focuses on the functional aspects of pain alleviation, these findings suggest psychological aspects of socialising satisfaction also impact pain experience. Pain management strategies should consider ways to increase social satisfaction in individuals with chronic pain, perhaps by facilitating socialisation in the home using remote communication methods similar to those which became popular during the COVID-19 lockdown.
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Affiliation(s)
- Bethany Donaghy
- School of Psychology, Liverpool John Moores University, Liverpool, England
- * E-mail:
| | - Susannah C. Walker
- School of Psychology, Liverpool John Moores University, Liverpool, England
| | - David J. Moore
- School of Psychology, Liverpool John Moores University, Liverpool, England
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72
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Birgegård A, Abbaspour A, Borg S, Clinton D, Mantilla EF, Savva A, Termorshuizen JD, Bulik CM. Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden. Eat Disord 2022; 30:602-617. [PMID: 34634228 DOI: 10.1080/10640266.2021.1985286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The study aimed to document the impact of the COVID-19 pandemic on the health and well-being of individuals with past and current eating disorders (ED) in Sweden. We re-contacted participants with a known lifetime history of ED from two previous Swedish studies. Participants completed an online survey about health and functioning at baseline early in the pandemic (Wave 1 ca May/June 2020; N= 982) and six months later (Wave 2 Dec/Jan 2020/21; N= 646). Three important patterns emerged: 1) higher current ED symptoms were associated with greater anxiety, worry, and pandemic-related ED symptom increase; 2) patterns were fairly stable across time, although a concerning percentage (23%) who were symptom-free at Wave 1 reported the re-emergence of symptoms at Wave 2; and 3) only a minority of participants (<50%) with a current ED were in treatment, and of those in treatment, many reported fewer treatment sessions and decreased quality of care. The COVID-19 pandemic appears to pose serious health challenges for individuals with an ED, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with ED and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.
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Affiliation(s)
- Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Afrouz Abbaspour
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Stina Borg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Clinton
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Emma Forsén Mantilla
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Androula Savva
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jet D Termorshuizen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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73
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Winters M, Biermann O, Bohlin G, Bergman M, Brounéus F, Zeebari Z, Nordenstedt H. Media use and trust during the COVID-19 pandemic: evidence from eight cross-sectional surveys in Sweden. Eur J Public Health 2022; 32:976-981. [PMID: 36223605 DOI: 10.1093/eurpub/ckac145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND While a lot has been written about Sweden's COVID-19 control strategy, less is known about Swedish residents' media use during the pandemic and trust in and perceived agreement among key stakeholders commenting in the media. METHODS Eight online, nationwide surveys were fielded between March and August 2020, during the first wave of the coronavirus pandemic in Sweden, with 8146 responses. Questions were asked on media usage, perceived tone of media, trust in key pandemic stakeholder groups commenting in the media (politicians, journalists, government officials, doctors/healthcare professionals and researchers) and perceived agreement among these key stakeholders about how the pandemic was handled in Sweden. RESULTS Using five or more information sources was associated with increased perceived alarmism in the media. Women and those with tertiary education were more likely to trust key pandemic actors. Trust in doctors/healthcare professionals and researchers remained high over the course of the study, trust in politicians and journalists was relatively low throughout the study period, with a slight increase in April 2020. Trust in key stakeholders was strongly associated with perceived agreement among the key stakeholders. CONCLUSIONS Our results show that trust in stakeholders was strongly associated with perceived consistency of messages from those stakeholders. The inverse also holds: perceived conflicting messages among stakeholders was associated with low trust in them. Taken together, this could point to the importance of building trust before a crisis. Trust-building efforts could be targeted to men and those with lower educational attainment, as they had lower trust in key stakeholders.
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Affiliation(s)
- Maike Winters
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Olivia Biermann
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Gustav Bohlin
- Public & Science (V&A), Stockholm, Sweden.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Economics, Finance and Statistics, Jönköping International Business School, Jönköping, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Exploring the Association between Negative Emotions and COVID-19 Vaccine Acceptance: A Cross-Sectional Analysis of Unvaccinated Adults in Sweden. Vaccines (Basel) 2022; 10:vaccines10101695. [PMID: 36298560 PMCID: PMC9608178 DOI: 10.3390/vaccines10101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on individuals’ mental health. This study aimed to investigate how negative emotions toward the COVID-19 pandemic, including feeling anxious, depressed, upset, and stressed, were associated with COVID-19 vaccine acceptance in Sweden. The study is a cross-sectional online survey conducted between 21–28 May 2021, using three nested hierarchical logistic regression models to assess the association. The study included 965 unvaccinated individuals, 51.2% (n = 494) of whom reported their intention to get vaccinated. We observed graded positive associations between reported negative emotions and vaccine acceptance. Individuals who experienced economic stress had lower odds of vaccine acceptance while having a positive opinion of the government’s response to COVID-19 was associated with higher odds of being vaccine-acceptant. In conclusion, unvaccinated individuals experiencing negative emotions about the pandemic were more willing to get the vaccine. On the contrary, those with a negative opinion about the government’s response, and those that had experienced economic stress were less likely to accept the immunization.
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75
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Elander I, Granberg M, Montin S. Governance and planning in a 'perfect storm': Securitising climate change, migration and Covid-19 in Sweden. PROGRESS IN PLANNING 2022; 164:100634. [PMID: 36217494 PMCID: PMC9535694 DOI: 10.1016/j.progress.2021.100634] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/12/2021] [Accepted: 10/26/2021] [Indexed: 06/16/2023]
Abstract
The article describes and reflects upon how multi-level governance and planning in Sweden have been affected by and reacted upon three pending major challenges confronting humanity, namely climate change, migration and the Covid-19 pandemic. These 'crises' are broadly considered 'existential threats' in need of 'securitisation'. Causes and adequate reactions are contested, and there are no given solutions how to securitise the perceived threats, neither one by one, no less together. Government securitisation strategies are challenged by counter-securitisation demands, and plaguing vulnerable groups in society by in-securitising predicaments. Taking Sweden as an example the article applies an analytical approach drawing upon strands of securitisation, governance and planning theory. Targeting policy responses to the three perceived crises the intricate relations between government levels, responsibilities, capacities, and actions are scrutinized, including a focus upon the role of planning. Overriding research questions are: How has the governance and planning system - central, regional and local governments - in Sweden responded to the challenges of climate change, migration and Covid-19? What threats were identified? What solutions were proposed? What consequences could be traced? What prospects wait around the corner? Comparing crucial aspects of the crises' anatomies the article adds to the understanding of the way multilevel, cross-sectional, hybrid governance and planning respond to concurrent crises, thereby also offering clues for action in other geopolitical contexts. The article mainly draws upon recent and ongoing research on manifestations of three cases in the Swedish context. Applying a pragmatic, methodological approach combining elements of securitisation, governance and planning theories with Carol Lee Bacchi's 'What is the problem represented to be' and a touch of interpretive/narrative theory, the study reveals distinct differences between the anatomies of the three crises and their handling. Urgency, extension, state of knowledge/epistemology, governance and planning make different imprints on crises management. Sweden's long-term climate change mitigation and adaptation strategies imply slow, micro-steps forward based on a combination of social-liberal, 'circular' and a touch of 'green growth' economies. Migration policy displays a Janus face, on the one hand largely respecting the UN refugee quota system on the other hand applying a detailed regulatory framework causing severe insecurity especially for minor refugees wanting to stay and make their living in Sweden. The Covid-19 outbreak revealed a lack of foresight and eroded/fragmented responsibility causing huge stress upon personnel in elderly and health care and appalling death rates among elderly patients, although governance and planning slowly adapted through securitising policies, leading to potential de-securitisation of the issue. The three crises have caused a security wake-up among governments at all levels and the public in general, and the article concludes by discussing whether this 'perfect storm' of crises will result in a farewell to neoliberalism - towards a neo-regulatory state facing further challenges and crises for governance, planning and the role of planners. The tentative prospect rather indicates a mixture of context-dependent 'hybrid governance', thus also underlining the crucial role of planners' role as 'chameleons' in complicated governance processes of politics, policy and planning.
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Affiliation(s)
| | - Mikael Granberg
- Political science and the Centre for Societal Risk Research, Karlstad University, SE- 651 88, Karlstad, Sweden
- The Centre for Natural Hazards and Disaster Science (CNDS), Uppsala University, 752 36 Uppsala, Sweden
- The Centre for Urban Research (CUR), RMIT University, Melbourne VIC 3000, Australia
| | - Stig Montin
- Gothenburg University, Box 712, SE- 411 23, Göteborg, Sweden
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Rosengren A, Lundberg CE, Söderberg M, Santosa A, Edqvist J, Lindgren M, Åberg M, Gisslén M, Robertson J, Cronie O, Sattar N, Lagergren J, Brandén M, Björk J, Adiels M. Severe COVID-19 in people 55 and older during the first year of the pandemic in Sweden. J Intern Med 2022; 292:641-653. [PMID: 35612518 PMCID: PMC9348046 DOI: 10.1111/joim.13522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Exposure to many contacts is the main risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while risk of serious disease and death is chiefly determined by old age and comorbidities. Relative and population-attributable fractions (PAFs) of multiple medical and social exposures for COVID-19 outcomes have not been evaluated among older adults. OBJECTIVES We describe the effect of multiple exposures on the odds of testing positive for the virus and of severe disease (hospital care or death) and PAFs in Swedish citizens aged 55 years and above. METHODS We used national registers to follow all citizens aged 55 years and above with respect to (1) testing positive, (2) hospitalization, and (3) death between 31 January 2020 and 1 February 2021. RESULTS Of 3,410,241 persons, 156,017 (4.6%, mean age 68.3 years) tested positive for SARS-CoV-2, while 35,999 (1.1%, mean age 76.7 years) were hospitalized or died (12,384 deaths, 0.4%, mean age 84.0 years). Among the total cohort, the proportion living without home care or long-term care was 98.8% among persons aged 55-64 and 22.1% of those aged 95 and above. After multiple adjustment, home care and long-term care were associated with odds ratios of 7.9 (95% confidence interval [CI] 6.8-9.1) and 22.5 (95% CI 19.6-25.7) for mortality, with PAFs of 21.9% (95% CI 20.9-22.9) and 33.3% (95% CI 32.4-34.3), respectively. CONCLUSION Among Swedish residents aged 55 years and above, those with home care or long-term care had markedly increased risk for COVID-19 death during the first year of the pandemic, with over 50% of deaths attributable to these factors.
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Affiliation(s)
- Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Christina E Lundberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mia Söderberg
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jon Edqvist
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Lindgren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Medicine, Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - Magnus Gisslén
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefina Robertson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ottmar Cronie
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Naveed Sattar
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Maria Brandén
- Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm University, Stockholm, Sweden.,Institute for Analytical Sociology (IAS), Linköping University, Norrköping, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.,Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Martin Adiels
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Sundberg E, Georgantzi K, Langenskiöld C, Król L, Nilsson F, Vogt H, Palle J, Ek T, Nilsson A. Low numbers of COVID-19 in Swedish pediatric oncology patients during the first pandemic year despite an open society. Pediatr Blood Cancer 2022; 69:e29750. [PMID: 35484955 PMCID: PMC9088657 DOI: 10.1002/pbc.29750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/07/2022] [Accepted: 04/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sweden adopted a different strategy than many other countries to combat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and kept most schools open. Initial reports from China suggested that coronavirus disease 2019 (COVID-19) was milder in children compared to adults, but there was a lack of data from immunocompromised children. Therefore, we investigated the rate of verified SARS-CoV-2 infections in our Swedish pediatric oncology patients. PROCEDURE This was a multicenter retrospective study. A questionnaire including patient data as well as SARS-CoV-2 data was sent to the six Swedish childhood cancer centers in May 2021. RESULTS During the first pandemic year, 49 patients were identified as SARS-CoV-2 positive, and 22 (45%) children were hospitalized with COVID-19. Two children needed intensive care, but no COVID-19-related deaths were reported. Most patients (n = 36, 73%) were on active chemotherapy treatment and 23 children (49%) attended school or daycare at least part-time. Half of the SARS-CoV-2-positive patients experienced a delay in cancer treatment. CONCLUSIONS Despite the rapid spread of SARS-CoV-2 in Sweden, without a strict lockdown of the society, the number of nationally reported pediatric oncology patients with polymerase chain reaction (PCR)-verified infection was low, and the majority of children had mild disease. Our data show that treatment interruptions occurred frequently and this should clearly be avoided for the coming years.
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Affiliation(s)
- Emil Sundberg
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Kleopatra Georgantzi
- Division of Pediatric Hematology‐OncologyTema Barn, Astrid Lindgren Children's HospitalStockholmSweden
| | | | - Ladislav Król
- Division of Pediatric Hematology‐OncologySkåne University HospitalLundSweden
| | - Frans Nilsson
- Division of Pediatric Hematology‐OncologyUmeå University HospitalUmeåSweden
| | - Hartmut Vogt
- Crown Princess Victoria's Child and Youth Hospital, Division of Pediatric Hematology‐Oncology B153, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Josefine Palle
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden
| | - Torben Ek
- Children's Cancer CentreQueen Silvia Children's HospitalGothenburgSweden
| | - Anna Nilsson
- Division of Pediatric Hematology‐OncologyTema Barn, Astrid Lindgren Children's HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetSolnaSweden
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78
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Kompani K, Deml MJ, Mahdavian F, Koval O, Arora S, Broqvist H. Who Said What: A Multi-Country Content Analysis of European Health Organisations’ COVID-19 Social Media Communication. Int J Public Health 2022; 67:1604973. [PMID: 36213137 PMCID: PMC9536133 DOI: 10.3389/ijph.2022.1604973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: As a risk communication tool, social media was mobilised at an unprecedented level during the COVID-19 pandemic. This study examined health authorities’ risk communication on social media in response to the pandemic in 2020.Methods: We analysed 1,633 COVID-19-related posts from 15 social media accounts managed by official health authorities in Germany, Norway, Sweden, Switzerland, and the United Kingdom.Results: The rate at which the authorities posted about COVID-19 on social media fluctuated throughout 2020. Each account’s posting frequency peaked between March and May 2020, before dropping considerably during the summer. The messages that the organisations focused on also varied throughout the year but covered most risk communication guidelines. Yet, our analysis highlighted themes that were communicated infrequently, such as long COVID or exercising during the pandemic.Conclusion: With more individuals now following health authorities on social media, platforms such as Instagram hold great potential for future risk communication campaigns and strategies.
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Affiliation(s)
- Kamyar Kompani
- Department of Sociology, Institute of Sociological Research, University of Geneva, Geneva, Switzerland
| | - Michael J. Deml
- Department of Sociology, Institute of Sociological Research, University of Geneva, Geneva, Switzerland
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Olena Koval
- Department of Safety, Economics and Planning, University of Stavanger, Stavanger, Norway
| | - Sanjana Arora
- Department of Safety, Economics and Planning, University of Stavanger, Stavanger, Norway
- *Correspondence: Sanjana Arora,
| | - Hilda Broqvist
- Department of Humanities and Social Sciences, Mid Sweden University, Östersund, Sweden
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79
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Ludvigsson JF. How Sweden approached the COVID-19 pandemic: Summary and commentary on the National Commission Inquiry. Acta Paediatr 2022; 112:19-33. [PMID: 36065136 PMCID: PMC9538368 DOI: 10.1111/apa.16535] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 12/13/2022]
Abstract
AIM Sweden initially chose a different disease prevention and control path during the pandemic than many other European countries. In June 2020, the Swedish Government established a National Commission to examine the management of COVID-19 in Sweden. This paper summarises, and discusses, its findings. METHODS Three reports published by the Commission were analysed. The first focused on the care of older people during the pandemic. The second examined disease and infection transmission and control and health care and public health. The third updated the first two reports and also covered economic aspects, crisis management and public communication. RESULTS By 25 February 2022, when the final report was published, 15 800 individuals, 1.5 per 1000 Swedish inhabitants, had died after COVID-19. The death rates were high in spring 2020, but overall excess mortality in 2020-2021 was +0.79%, which was lower than in many other European countries. The Commission suggested that the voluntary measures that were adopted were appropriate and maintained Swedes' personal freedom during the pandemic. However, more extensive and earlier measures should have been taken, especially during the first wave. CONCLUSION The Swedish COVID-19 Commission felt that earlier and more extensive pandemic action should have been taken, particularly during the first wave.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of PaediatricsÖrebro University HospitalÖrebroSweden,Department of MedicineColumbia University College of Physicians and SurgeonsNew YorkNew YorkUSA
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80
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Gustafsson PE, Schröders J, Nilsson I, San Sebastián M. Surviving Through Solitude: A Prospective National Study of the Impact of the Early COVID-19 Pandemic and a Visiting Ban on Loneliness Among Nursing Home Residents in Sweden. J Gerontol B Psychol Sci Soc Sci 2022; 77:2286-2295. [PMID: 36055339 PMCID: PMC9494329 DOI: 10.1093/geronb/gbac126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Targeted social distancing measures were widely implemented for nursing home residents when the extremely high coronavirus disease 2019 mortality in this setting became apparent. However, there is still scarce rigorous research examining how the pandemic and accompanying social distancing measures affected loneliness in this group. This prospective nationwide Swedish study of nursing home residents aimed to examine the impact on loneliness of the early phase of the pandemic and of a national visiting ban at nursing homes. METHODS A panel was selected from a total population survey of all nursing home residents in Sweden March-May 2019 and 2020 (N = 11,782; age range 70-110 years; mean age 88.2 years; 71% women). Prospective pretest-posttest and controlled interrupted time series (ITS) designs were employed, with time trends estimated by date of returned questionnaire. Generalized linear models were used for estimation of effects, adjusting for demographic-, survey-, and health-related covariates. RESULTS Loneliness prevalence increased from 17% to 19% from 2019 to 2020 (risk ratio, RR (95% confidence interval, CI) = 1.104 (1.060; 1.150)), but which was explained by self-reported health (RR (95% CI) = 1.023 (0.982; 1.066)). No additional impact of the visiting ban on loneliness trends was found in the ITS analyses (RR (95% CI) = 0.984 (0.961; 1.008)). DISCUSSION The moderate but health-dependent increased risk of loneliness, and the lack of impact of the nationwide visiting ban at nursing homes, suggests that this ostensibly vulnerable group of nursing home residents also shows signs of resilience, at least during the early phase of the pandemic.
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Affiliation(s)
- Per E Gustafsson
- Address correspondence to: Per E. Gustafsson, PhD, Department of Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden. E-mail:
| | - Julia Schröders
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden,Department of Sociology, Umeå University, Umeå, Sweden
| | - Ingeborg Nilsson
- Department of Community Medicine and Rehabilitation, Unit of Occupational Therapy, Umeå University, Umeå, Sweden
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Axenhus M, Schedin-Weiss S, Winblad B, Wimo A. Changes in mortality trends amongst common diseases during the COVID-19 pandemic in Sweden. Scand J Public Health 2022; 50:748-755. [PMID: 34933630 PMCID: PMC9361422 DOI: 10.1177/14034948211064656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE It has been found that COVID-19 increases deaths within common diseases in countries that have implemented strict lockdowns. In order to elucidate the proper national response to a pandemic, the mortality rates within COVID-19 and various diseases need to be studied in countries whose pandemic response differ. Sweden represents a country with lax pandemic restrictions, and we aimed to study the effects of COVID-19 on historical mortality rates within common diseases during 2020. METHODS Regression models and moving averages were used to predict expected premature mortality per the ICD-10 during 2020 using historical data sets. Predicted values were then compared to recorded premature mortality to identify changes in mortality trends. RESULTS Seasonal increased mortality was found within neurological diseases. Infectious diseases, tumours and cardiac disease mortality rates decreased compared to expected outcome. CONCLUSIONS Changes in mortality trends were observed for several common diseases during the COVID-19 pandemic. Neurological and cardiac conditions, infections and tumours are examples of diseases that were heavily affected by the pandemic. The indirect effects of COVID-19 on certain patient populations should be considered when determining pandemic impact.
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Affiliation(s)
- Michael Axenhus
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
- Theme Inflammation and Aging,
Karolinska University Hospital, Sweden
| | - Sophia Schedin-Weiss
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
| | - Bengt Winblad
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
- Theme Inflammation and Aging,
Karolinska University Hospital, Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Centre for
Alzheimer Research, Department of Neurobiology, Care Sciences and Society,
Karolinska Institutet, Sweden
- Primary Care, Hudiksvall-Nordanstig,
Sweden
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82
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Tobik ER, Kitfield-Vernon LB, Thomas RJ, Steel SA, Tan SH, Allicock OM, Choate BL, Akbarzada S, Wyllie AL. Saliva as a sample type for SARS-CoV-2 detection: implementation successes and opportunities around the globe. Expert Rev Mol Diagn 2022; 22:519-535. [PMID: 35763281 DOI: 10.1080/14737159.2022.2094250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Symptomatic testing and asymptomatic screening for SARS-CoV-2 continue to be essential tools for mitigating virus transmission. Though COVID-19 diagnostics initially defaulted to oropharyngeal or nasopharyngeal sampling, the worldwide urgency to expand testing efforts spurred innovative approaches and increased diversity of detection methods. Strengthening innovation and facilitating widespread testing remains critical for global health, especially as additional variants emerge and other mitigation strategies are recalibrated. AREAS COVERED A growing body of evidence reflects the need to expand testing efforts and further investigate the efficiency, sensitivity, and acceptability of saliva samples for SARS-CoV-2 detection. Countries have made pandemic response decisions based on resources, costs, procedures, and regional acceptability - the adoption and integration of saliva-based testing among them. Saliva has demonstrated high sensitivity and specificity while being less invasive relative to nasopharyngeal swabs, securing saliva's position as a more acceptable sample type. EXPERT OPINION Despite the accessibility and utility of saliva sampling, global implementation remains low compared to swab-based approaches. In some cases, countries have validated saliva-based methods but face challenges with testing implementation or expansion. Here, we review the localities that have demonstrated success with saliva-based SARS-CoV-2 testing approaches and can serve as models for transforming concepts into globally-implemented best practices.
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Affiliation(s)
- Emily R Tobik
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Lily B Kitfield-Vernon
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Russell J Thomas
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Sydney A Steel
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Steph H Tan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA.,Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Orchid M Allicock
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Brittany L Choate
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Sumaira Akbarzada
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Anne L Wyllie
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
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83
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Tishelman C, Degen JL, Weiss Goitiandía S, Kleijberg M, Kleeberg-Niepage A. A Qualitative Serial Analysis of Drawings by Thirteen-to Fifteen-Year-Old Adolescents in Sweden About the First Wave of the Covid-19 Pandemic. QUALITATIVE HEALTH RESEARCH 2022; 32:1370-1385. [PMID: 35599585 PMCID: PMC9350847 DOI: 10.1177/10497323221101978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this article, we explore the perspectives of 13-15-year-olds living in Sweden about the first wave of the Covid-19 pandemic, through inductive analysis of 187 of their drawings. Through reconstructive serial picture analysis, three types of meaning were derived: (1) A new normal in dystopian scenery points to the disruption of daily life and development of new praxis and meaning in a context of threat and restriction; (2) Disrupted relationships refers to these adolescents' self-portrayal as solitary, without adult guidance or friends prominent; and (3) Negative emotions and compliant behaviors addresses a range of negative emotions and expressions of loss with few proactive strategies illustrated. General existential distress appears in these drawings, seemingly compounded by both developmental stage and other factors in addition to the pandemic context. Drawings suggest a restricted repertoire of ways of dealing with challenges confronting these adolescents, who seemed to feel left to their own resources.
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Affiliation(s)
- Carol Tishelman
- Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- The Center for Health Economics,
Informatics and Health Care Research (CHIS), Stockholm Health Care Services
(SLSO), Region Stockholm, Sweden
| | - Johanna L. Degen
- Department of Psychology, European University of Flensburg, Flensburg, Germany
| | | | - Max Kleijberg
- Department of Neurobiology, Care Sciences
and Society, Karolinska Institutet, Stockholm, Sweden
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84
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Ernudd I, Älgå A, Sandblom G, Dahlberg M, Mantel Ä. Treatment strategies and perforation rate of acute appendicitis during the early phase of the Covid-19 Pandemic: A Swedish cohort study. J Surg Res 2022; 280:450-458. [PMID: 36054956 PMCID: PMC9283669 DOI: 10.1016/j.jss.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 01/08/2023]
Abstract
Introduction It is unknown whether the COVID-19 pandemic has had an impact on emergency surgical care in Sweden. This study aimed to compare frequency, treatment strategies, severity, and complication rate of appendicitis during the initial phase of the COVID-19 pandemic with those of previous years. Methods In this single-center study, we identified all patients admitted with appendicitis between March 16 and June 16, 2020, at the Stockholm South General Hospital, and compared these with patients hospitalized with appendicitis during the same calendar period the three previous years. We used multivariate logistic regression to calculate Odds Ratios (OR) with 95% confidence intervals as measurement of the association between appendicitis treatment and perforation rate during the COVID-19 period compared to the nonCOVID-19 periods. Results In all, 892 patients hospitalized with appendicitis were identified, 241 (27%) in 2020 (Covid period group) and the remaining 651 (73%) during the same calendar periods 2017-2019 (nonCovid period group). Appendicitis during the COVID-19 period was associated with double the risk for undergoing conservative treatment (OR 2.15 [95% CI 1.44-3.21]), and a decreased risk for being diagnosed with perforated appendicitis (OR 0.68 [95% CI 0.48-0.98]). Conclusions Patients admitted with appendicitis during the early phase of the COVID-19 pandemic in Stockholm, Sweden, were more likely to receive conservative treatment and less likely to suffer from perforated appendicitis compared to patients hospitalized before the pandemic. Hypothetically, this difference could have been due to pandemic-associated resource reallocation, or it may simply reflect an increasing trend towards conservative management of appendicitis.
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Affiliation(s)
- Ivan Ernudd
- Surgical Department, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
| | - Andreas Älgå
- Surgical Department, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Gabriel Sandblom
- Surgical Department, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Martin Dahlberg
- Surgical Department, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Ängla Mantel
- Department of Medicine, Solna, Sweden; Division of Clinical Epidemiology, Karolinska Institute, Stockholm, Sweden
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85
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Larsson AC, Engwall M, Palstam A, Persson HC. Self-Assessed Aspects of Health 3 Months after COVID-19 Hospitalization—A Swedish Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138020. [PMID: 35805677 PMCID: PMC9265939 DOI: 10.3390/ijerph19138020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022]
Abstract
It is not yet fully understood how the patients self-assess their overall health in the early recovery after COVID-19 and if certain patient groups are more prominent in perceived long-time effects of COVID-19. The aim of this study was to describe self-assessed aspects of health in body function, activity and participation 3 months after hospitalization due to COVID-19 and identify difference between groups depending in age, sex and level of hospital care. This cross-sectional study consists of self-assessed aspects of health and recovery in 168 participants (mean age 64 years old, 69% men) previously hospitalized patients due to COVID-19. We have previously published data, from hospital discharge, on this cohort were predominantly the older patients and previous ICU-treated participants were affected. In this study there were differences in between groups. Of the study population 72% perceived fatigue, 64% respiratory difficulties, 37% perceived symptoms of anxiety. Three-months after COVID-19 this cohort was overall still affected. The recovery process is multifaced and the cohort heterogeneous, hence the rehabilitation needs to be highly individualized, and the follow-up of this patient group is of importance regardless of age, sex and previous level of hospital care.
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Affiliation(s)
- Alexandra C. Larsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.E.); (A.P.); (H.C.P.)
- Department of Occupational Therapy and Physical Therapy, Sahlgrenska University Hospital, 413 46 Gothenburg, Sweden
- Correspondence:
| | - Marie Engwall
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.E.); (A.P.); (H.C.P.)
- Department of Health Sciences, University West, 461 32 Trollhattan, Sweden
| | - Annie Palstam
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.E.); (A.P.); (H.C.P.)
- Department NeuroScience, Sahlgrenska University Hospital, 413 46 Gothenburg, Sweden
- School of Health and Welfare, Dalarna University, 791 31 Falun, Sweden
| | - Hanna C. Persson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; (M.E.); (A.P.); (H.C.P.)
- Department of Occupational Therapy and Physical Therapy, Sahlgrenska University Hospital, 413 46 Gothenburg, Sweden
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86
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Wang X, Wallentin FY, Yin L. The statistical evidence missing from the Swedish decision-making of COVID-19 strategy during the early period: A longitudinal observational analysis. SSM Popul Health 2022; 18:101083. [PMID: 35386859 PMCID: PMC8968210 DOI: 10.1016/j.ssmph.2022.101083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/07/2022] Open
Abstract
A controversy about the Swedish strategy of dealing with COVID-19 during the early period is how decision-making was based on evidence, which refers to data and data analysis. During the earliest period of the pandemic, the Swedish decision-making was based on subjective perspective. However, when more data became available, the decision-making stood on mathematical and descriptive analyses. The mathematical analysis aimed to model the condition for herd immunity while the descriptive analysis compared different measures without adjustment of population differences and updating pandemic situations. Due to the dubious interpretations of these analyses, a mild measure was adopted in Sweden upon the arrival of the second wave, leading to a surge of poor public health outcomes compared to the other Nordic countries (Denmark, Norway, and Finland). In this article, using data available during the first wave, we conduct longitudinal analysis to investigate the consequence of the shred of evidence in the Swedish decision-making for the first wave, where the study period is between January 2020 and August 2020. The design is longitudinal observational study. The linear regressions based on the Poisson distribution and the binomial distribution are employed for the analysis. We found that the early Swedish measure had a long-term and significant effect on general mortality and COVID-19 mortality and a certain mitigating effect on unemployment in Sweden during the first wave; here, the effect was measured by an increase of general deaths, COVID-19 deaths or unemployed persons under Swedish measure relative to the measures adopted by the other Nordic countries. These pieces of statistical evidence were not studied in the mathematical and descriptive analyses but could play an important role in the decision-making at the second wave. In conclusion, a timely longitudinal analysis should be part of the decision-making process for containing the current pandemic or a future one. Different measures led to different public health and economic outcomes of COVID-19. Decision-making of these measures was based on evidences, but Which evidences were used during the dramatic first wave of COVID-19?
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87
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Nakitanda AO, Karlsson P, Löfling L, Cesta CE, Odsbu I. Antimicrobial use in Sweden during the COVID-19 pandemic: prescription fill and inpatient care requisition patterns. BMC Infect Dis 2022; 22:492. [PMID: 35610597 PMCID: PMC9128331 DOI: 10.1186/s12879-022-07405-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 04/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background Increased and inappropriate antimicrobial use are the key drivers of the emergence of antimicrobial resistance, and there have been widespread concerns around potential antimicrobial misuse, overuse and their consequences during the COVID-19 pandemic. To better understand the impact of the pandemic on antimicrobial use, particularly in light of the resurgence of COVID-19 cases since the summer of 2020, we assessed trends in antimicrobial prescription fills and hospital requisitions in Sweden during 2020 against those of preceding years. Methods We performed a descriptive study using population-based data from the Swedish Prescribed Drug Register and the Swedish e-Health Agency. The weekly number of prescriptions filled and the total volume sold to inpatient care institutions in defined daily doses (DDDs) per 1000 inhabitants for systemic antibacterials (Anatomical Therapeutic Chemical therapeutic subgroup J01 excluding J01XX), antimycotics (J02), antivirals (J05) and antiprotozoals (P01) were computed and evaluated from time series graphs. A time series linear regression with ordinary least squares (OLS) estimation was used to model 2015–2019 data and predict the expected number of prescriptions filled and volumes sold in DDDs per 1000 inhabitants during 2020 with 95% confidence limits. Results From mid-March 2020, the weekly rate of antibiotic and antiprotozoal prescriptions filled plummeted to unprecedentedly low levels for the rest of the year; while unprecedentedly high numbers of antiviral prescriptions were filled weekly between mid-February and mid-March 2020. There was a net reduction in annual dispensing of antibiotics by 17%; of antiprotozoals by 21%; and of antivirals by 0.3% during 2020 compared to 2019. Inpatient care requisitions of antiprotozoals and antibiotics surged to 6-year highs during March 2020, resulting in a 127% increase in DDDs of antiprotozoals sold from 2019. The volume of antibiotics and antivirals sold to inpatient care institutions in 2020 decreased by 3% and 13% compared to 2019, respectively. Conclusions The overall decline in antimicrobial prescriptions filled in Sweden during 2020 were in part, collateral dividends of the COVID-19 pandemic. Supplementary information The online version contains supplementary material available at 10.1186/s12879-022-07405-3.
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Affiliation(s)
- Aya Olivia Nakitanda
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T4, Maria Aspmans gata 30A, 17176, Stockholm, Sweden.
| | - Pär Karlsson
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T4, Maria Aspmans gata 30A, 17176, Stockholm, Sweden
| | - Lukas Löfling
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T4, Maria Aspmans gata 30A, 17176, Stockholm, Sweden.,Section for Epidemiology and Prevention, Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Carolyn E Cesta
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T4, Maria Aspmans gata 30A, 17176, Stockholm, Sweden
| | - Ingvild Odsbu
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T4, Maria Aspmans gata 30A, 17176, Stockholm, Sweden.,Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
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88
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Gustafsson PE, Nilsson I, San Sebastian M. Venerable vulnerability or remarkable resilience? A prospective study of the impact of the first wave of the COVID-19 pandemic and quarantine measures on loneliness in Swedish older adults with home care. BMJ Open 2022; 12:e060209. [PMID: 35613816 PMCID: PMC9130667 DOI: 10.1136/bmjopen-2021-060209] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the early impact of the pandemic and of quarantine measures targeting older adults introduced in March 2020 on loneliness among older adults in Sweden.Design Prospective pretest-posttest and controlled interrupted time series designs. SETTING The population of older adults receiving home care before and during the emergence of the first COVID-19 pandemic wave in Sweden in Spring 2020. PARTICIPANTS Respondents (n=45 123, mean age 85.6 years, 67.6% women) came from two waves of a total population survey targeting all community-dwelling older adults receiving home care for older adults in Sweden in Spring 2019 and 2020. OUTCOME Self-reported loneliness. RESULTS Results estimated 14% (95% CI: 10 to 19) higher loneliness in Spring 2020 compared with 2019, taking covariates into account. No impact of the quarantine measure was found (1% increase, 95% CI: -1 to 4). CONCLUSIONS The results illustrate the broader public health consequences of the COVID-19 pandemic for older adults, but also suggest a relative resilience among older adults in home care to quarantine measures, at least during the first months of the pandemic. Future studies should examine the long-term effects of sustained pandemic and social distancing measures on loneliness among older adults.
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Affiliation(s)
- Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umea, Sweden
| | - Ingeborg Nilsson
- Department of Community Medicine and Rehabilitation, Division of Occupational Therapy, Umeå University, Umea, Sweden
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89
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The association between maternal characteristics and SARS-CoV-2 in pregnancy: a population-based registry study in Sweden and Norway. Sci Rep 2022; 12:8355. [PMID: 35589871 PMCID: PMC9120467 DOI: 10.1038/s41598-022-12395-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/10/2022] [Indexed: 01/08/2023] Open
Abstract
The objectives of the current study were to identify risk factors for SARS-CoV-2 positivity, and to address how different testing strategies, choice of comparison group, and population background characteristics may influence observed associations. National registries data for 107,627 pregnant women in Sweden and 81,195 in Norway, were used to identify risk factors for SARS-CoV-2, separately for women under non-universal testing (testing by indication) and universal testing (testing of all pregnant women in contact with a delivery ward). We also investigated underlying characteristics associated with testing for SARS-CoV-2. Overall, 2.1% of pregnant women in Sweden and 1.1% in Norway were test-positive during the pandemic’s first 18 months. We show that the choice of test strategy for SARS-CoV-2 provided different associations with risk factors for the disease; for instance, women who were overweight, obese or had gestational diabetes had increased odds of being test-positive under non-universal testing, but not under universal testing. Nevertheless, a consistent pattern of association between being born in the Middle East and Africa and test-positivity was found independent of test strategy and in both countries. These women were also less likely to get tested. Our results are useful to consider for surveillance and clinical recommendations for pregnant women during the current and future pandemics.
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90
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Ivarsson L, de Arriba Sánchez de la Campa M, Elfving K, Yin H, Gullsby K, Stark L, Andersen B, Hoffmann S, Gylfe Å, Unemo M, Herrmann B. Changes in testing and incidence of Chlamydia trachomatis and Neisseria gonorrhoeae – the possible impact of the COVID-19 pandemic in the three Scandinavian countries. Infect Dis (Lond) 2022; 54:623-631. [DOI: 10.1080/23744235.2022.2071461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Lovisa Ivarsson
- Department of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Magdalena de Arriba Sánchez de la Campa
- Department of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Karin Elfving
- Department of Clinical Microbiology, Laboratory Medicine, Falu Hospital, Falun, Sweden
| | - Hong Yin
- Department of Clinical Microbiology, Laboratory Medicine, Falu Hospital, Falun, Sweden
| | - Karolina Gullsby
- Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Lisa Stark
- Department of Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden
| | - Berit Andersen
- University Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, Denmark
- Department for Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steen Hoffmann
- Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Åsa Gylfe
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, Örebro University Hospital, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, United Kingdom
| | - Björn Herrmann
- Department of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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91
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App-based COVID-19 syndromic surveillance and prediction of hospital admissions in COVID Symptom Study Sweden. Nat Commun 2022; 13:2110. [PMID: 35449172 PMCID: PMC9023535 DOI: 10.1038/s41467-022-29608-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/24/2022] [Indexed: 11/08/2022] Open
Abstract
The app-based COVID Symptom Study was launched in Sweden in April 2020 to contribute to real-time COVID-19 surveillance. We enrolled 143,531 study participants (≥18 years) who contributed 10.6 million daily symptom reports between April 29, 2020 and February 10, 2021. Here, we include data from 19,161 self-reported PCR tests to create a symptom-based model to estimate the individual probability of symptomatic COVID-19, with an AUC of 0.78 (95% CI 0.74–0.83) in an external dataset. These individual probabilities are employed to estimate daily regional COVID-19 prevalence, which are in turn used together with current hospital data to predict next week COVID-19 hospital admissions. We show that this hospital prediction model demonstrates a lower median absolute percentage error (MdAPE: 25.9%) across the five most populated regions in Sweden during the first pandemic wave than a model based on case notifications (MdAPE: 30.3%). During the second wave, the error rates are similar. When we apply the same model to an English dataset, not including local COVID-19 test data, we observe MdAPEs of 22.3% and 19.0% during the first and second pandemic waves, respectively, highlighting the transferability of the prediction model. The app-based COVID Symptom Study was launched in Sweden in April 2020 to contribute to real-time COVID-19 surveillance using daily symptom reports from study participants. Here, the authors show how syndromic surveillance can be used to estimate regional COVID-19 prevalence and to predict later COVID-19 hospital admissions.
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92
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Fäldt AE, Klint F, Warner G, Sarkadi A. Experiences of children with disabilities during the COVID-19 pandemic in Sweden: a qualitative interview study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001398. [PMID: 36053617 PMCID: PMC8983410 DOI: 10.1136/bmjpo-2021-001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/16/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The impact of the COVID-19 pandemic on people with disabilities has been described as a 'triple jeopardy'. Not only have they experienced the negative social impacts of disease control measures, but access to required health services has been affected, and, not least, they are at increased risk of severe outcomes from COVID-19. This study aimed to determine how children with disabilities have experienced the pandemic in Sweden and its impact on their lives. METHODS Six children (5-13 years) were interviewed via video conferencing. An interview guide was adapted based on the children's communicative abilities and included augmentative and alternative communication support. Reflective field notes were included in the analysis. The data were analysed using qualitative content analysis. RESULTS Two themes were identified: The child's knowledge of Corona raises anxiety and fear; and Boring Corona makes the child even lonelier. The children had knowledge about and were worried about COVID-19, primarily about illness and death of their grandparents. The children longed for their grandparents and other social contacts at school, and life was described as boring and lonely. Many families lacked adequate tools to communicate with their children about the pandemic. CONCLUSION Given adequate support, children with disabilities and communication difficulties can give insights to their unique life situations. The interviewed children reported significant impact on their life and school life. Children were worried about their grandparents based on their knowledge about the virus. The enthusiasm with which the children engaged in the interviews is testament to the need and right of all children, regardless of communicative competence, to voice their experiences.
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Affiliation(s)
- Anna Erica Fäldt
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Filippa Klint
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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93
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Oakley LL, Örtqvist AK, Kinge J, Hansen AV, Petersen TG, Söderling J, Telle KE, Magnus MC, Mortensen LH, Nybo Andersen AM, Stephansson O, Håberg SE. Preterm birth after the introduction of COVID-19 mitigation measures in Norway, Sweden, and Denmark: a registry-based difference-in-differences study. Am J Obstet Gynecol 2022; 226:550.e1-550.e22. [PMID: 34774824 PMCID: PMC8648397 DOI: 10.1016/j.ajog.2021.11.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although some studies have reported a decrease in preterm birth following the start of the COVID-19 pandemic, the findings are inconsistent. OBJECTIVE This study aimed to compare the incidences of preterm birth before and after the introduction of COVID-19 mitigation measures in Scandinavian countries using robust population-based registry data. STUDY DESIGN This was a registry-based difference-in-differences study using births from January 2014 through December 2020 in Norway, Sweden, and Denmark. The changes in the preterm birth (<37 weeks) rates before and after the introduction of COVID-19 mitigation measures (set to March 12, 2020) were compared with the changes in preterm birth before and after March 12 from 2014 to 2019. The differences per 1000 births were calculated for 2-, 4-, 8-, 12-, and 16-week intervals before and after March 12. The secondary analyses included medically indicated preterm birth, spontaneous preterm birth, and very preterm (<32 weeks) birth. RESULTS A total of 1,519,521 births were included in this study. During the study period, 5.6% of the births were preterm in Norway and Sweden, and 5.7% were preterm in Denmark. There was a seasonal variation in the incidence of preterm birth, with the highest incidence during winter. In all the 3 countries, there was a slight overall decline in preterm births from 2014 to 2020. There was no consistent evidence of a change in the preterm birth rates following the introduction of COVID-19 mitigation measures, with difference-in-differences estimates ranging from 3.7 per 1000 births (95% confidence interval, -3.8 to 11.1) for the first 2 weeks after March 12, 2020, to -1.8 per 1000 births (95% confidence interval, -4.6 to 1.1) in the 16 weeks after March 12, 2020. Similarly, there was no evidence of an impact on medically indicated preterm birth, spontaneous preterm birth, or very preterm birth. CONCLUSION Using high-quality national data on births in 3 Scandinavian countries, each of which implemented different approaches to address the pandemic, there was no evidence of a decline in preterm births following the introduction of COVID-19 mitigation measures.
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Affiliation(s)
- Laura L. Oakley
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway,Corresponding author: Laura L. Oakley, PhD
| | - Anne K. Örtqvist
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden,Department of Obstetrics and Gynaecology, Visby County Hospital, Visby, Sweden
| | - Jonas Kinge
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway,University of Oslo, Oslo, Norway
| | - Anne Vinkel Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark,Statistics Denmark, Copenhagen, Denmark
| | - Tanja Gram Petersen
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Jonas Söderling
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Kjetil E. Telle
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria C. Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway,Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway,MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Laust Hvas Mortensen
- Statistics Denmark, Copenhagen, Denmark,Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | | | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden,Department of Women's Health, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Siri E. Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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94
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Ghazi SN, Anderberg P, Berglund JS, Berner J, Dallora AL. Psychological Health and Digital Social Participation of the Older Adults during the COVID-19 Pandemic in Blekinge, Sweden-An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063711. [PMID: 35329398 PMCID: PMC8954168 DOI: 10.3390/ijerph19063711] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/04/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023]
Abstract
COVID-19 has affected the psychological health of older adults directly and indirectly through recommendations of social distancing and isolation. Using the internet or digital tools to participate in society, one might mitigate the effects of COVID-19 on psychological health. This study explores the social participation of older adults through internet use as a social platform during COVID-19 and its relationship with various psychological health aspects. In this study, we used the survey as a research method, and we collected data through telephonic interviews; and online and paper-based questionnaires. The results showed an association of digital social participation with age and feeling lack of company. Furthermore, in addition, to the increase in internet use in older adults in Sweden during COVID-19, we conclude that digital social participation is essential to maintain psychological health in older adults.
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Affiliation(s)
- Sarah Nauman Ghazi
- Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; (P.A.); (J.S.B.); (J.B.); (A.L.D.)
- Correspondence:
| | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; (P.A.); (J.S.B.); (J.B.); (A.L.D.)
- School of Health Sciences, University of Skövde, SE-541 28 Skövde, Sweden
| | - Johan Sanmartin Berglund
- Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; (P.A.); (J.S.B.); (J.B.); (A.L.D.)
| | - Jessica Berner
- Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; (P.A.); (J.S.B.); (J.B.); (A.L.D.)
| | - Ana Luiza Dallora
- Department of Health, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden; (P.A.); (J.S.B.); (J.B.); (A.L.D.)
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95
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Schechter-Perkins EM, van den Berg P, Branch-Elliman W. The Science Behind Safe School Re-opening: Leveraging the Pillars of Infection Control to Support Safe Elementary and Secondary Education During the COVID-19 Pandemic. Open Forum Infect Dis 2022; 9:ofab134. [PMID: 35141343 PMCID: PMC7989186 DOI: 10.1093/ofid/ofab134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/16/2021] [Indexed: 12/23/2022] Open
Abstract
There are limited tools for adapting coronavirus disease 2019 (COVID-19) infection control plans to school settings. We present an infection prevention model for optimizing safe re-opening for elementary and secondary schools during the global COVID-19 pandemic and review the current evidence behind various infection prevention interventions in school settings. The model is adapted from the Centers for Disease Control and Prevention fundamental pillars for infection prevention and includes 4 categories of intervention: epidemiologic controls (town prevalence metrics, diagnostic testing, quarantine strategies), administrative controls (state vaccination policies, alternative school models, symptom screens, quarantine breaks), engineering/environmental controls (distancing, outdoor space, ventilation), and personal protective equipment (PPE)/hand hygiene (face coverings, hand sanitizing). The adapted infection control pillars model utilizes implementation science-informed considerations to maximize pragmatism and adherence by leveraging evidence-based strategies. It highlights the necessity of redundant infection prevention interventions, acknowledges the importance of community buy-in to achieve real-world effectiveness, and addresses tactics to overcome implementation barriers. Recommendations are grounded in the Dynamic Sustainability Framework and include suggestions to maintain infection prevention effectiveness over time to ensure ongoing safety.
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Affiliation(s)
- Elissa M Schechter-Perkins
- Department of Emergency Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Polly van den Berg
- Beth Israel Deaconess Medical Center, Department of Medicine, Section of Infectious Diseases, Boston, Massachusetts, USA
| | - Westyn Branch-Elliman
- Section of Infectious Diseases, Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- VA Boston Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA
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96
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Kapetanovic S, Ander B, Gurdal S, Sorbring E. Adolescent smoking, alcohol use, inebriation, and use of narcotics during the Covid-19 pandemic. BMC Psychol 2022; 10:44. [PMID: 35219325 PMCID: PMC8881938 DOI: 10.1186/s40359-022-00756-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background The aim of the study was to investigate how general family relations, reported changes in family interaction and involvement with peers during the Covid-19 pandemic, and following rules and recommendations during the pandemic relate to adolescent smoking, alcohol use, inebriation, and use of narcotics during Covid-19.
Methods An online national survey of Swedish adolescents (n = 1818) aged 15–19 years was conducted in June 2020. Hierarchical regression analysis was used to predict adolescents’ reported change in substance use during the pandemic. Person-oriented analyses, were used to identify clusters of participants characterized by similar patterns of substance use following ANOVA analysis with Scheffe post hoc tests testing differences between clusters in terms of family relations, reported changes in family interaction and involvement with peers during the Covid-19 pandemic, and following rules and recommendations during the pandemic. Results Higher general family conflict, increased involvement with peers, a strained relationship with parents, and less compliance with rules and restrictions during the pandemic predicted a reported increase in adolescent substance use during this period. The grouping of scores for adolescent smoking, alcohol use, inebriation, and use of narcotics resulted in a six-cluster solution. One cluster (n = 767) either did not use or had decreased use of substances during the Covid-19 pandemic. Five other clusters, thus risk clusters, had retained or increased use of substances during the pandemic. Poor general family relations, increased peer involvement, and difficulties to conform to the rules and restrictions during the covid-19 pandemic were characteristics of risk clusters. Conclusions Most of adolescents in our study did not increase their substance use during the pandemic. However, adolescents with poor family relations who turn to peers during stressful times and who have difficulty following the government’s rules and restrictions, are at risk of increased substance use during the pandemic. This is a potential threat both to adolescents themselves and others in their surroundings which is why at-risk adolescents and their families need more attention from public health and social services during this time of crisis.
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Affiliation(s)
- Sabina Kapetanovic
- Department of Social and Behavioral Studies, University West, Gustava Melinsgata 2, 46132, Trollhättan, Sweden. .,Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Birgitta Ander
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Sevtap Gurdal
- Department of Social and Behavioral Studies, University West, Gustava Melinsgata 2, 46132, Trollhättan, Sweden
| | - Emma Sorbring
- Department of Social and Behavioral Studies, University West, Gustava Melinsgata 2, 46132, Trollhättan, Sweden
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97
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Bäckström D, Wladis A. A cohort study of trauma patients in Sweden during the first months of the COVID-19 pandemic: a small reduction in trauma admissions. Scand J Trauma Resusc Emerg Med 2022; 30:12. [PMID: 35183237 PMCID: PMC8857878 DOI: 10.1186/s13049-022-01001-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Given that Swedish authorities have been widely viewed as having practiced an unusual approach to the COVID-19 pandemic and given that Sweden is notable for a low incidence of trauma, we wanted to learn how the pandemic may have affected the number of trauma admissions in Sweden. Methods We conducted a retrospective cohort study based on the Swedish trauma registry (Svenska Traumaregistret). The study period was March 1, 2020 to June 30, 2020. As a basis for comparison, the record for the same time during the previous year, 2019 was used. Results During the four months of the first wave of COVID-19, 2020 there was a decline of 24.2% in the total number of trauma patients in Sweden. There was no significant change in 30-day mortality rates, 4.7% 2019 and 5.1% 2020, (p = 0.30). The number of injuries per patient was higher during the pandemic 3.8 injuries 2019 and 4.1 injuries 2020 (p = 0.02). The NISS 6, 2019 and 8, 2020 was higher during the pandemic. Conclusions As a consequence of what were seen by many as all too lenient actions taken to deal with COVID-19 in Sweden during spring 2020, there was still a reduction in trauma admissions most likely due to an adherence to the voluntary recommendations, the reduction was not as prominent as what was seen in many countries with harsher restrictions and lockdowns.
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98
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Rydström LL, Ångström-Brännström C, Blake L, Brayl L, Carter B, Forsner M, Matsson J, Nilsson S, Jenholt Nolbris M, Kirton J, Kull I, Protheroe J, Rullander AC, Saron H, Lindholm Olinder A. How children in Sweden accessed and perceived information during the first phase of the Covid-19 pandemic. Scand J Public Health 2022; 50:144-151. [PMID: 34736348 PMCID: PMC8807992 DOI: 10.1177/14034948211051884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To describe how children in Sweden accessed and perceived information about SARS-CoV2 and Covid-19 during the first phase of the outbreak. METHODS This study is a substudy of an international cross-sectional online mixed methods survey examining elements of children's health literacy in relation to Covid-19. The survey included multiple-choice questions, open-ended questions and drawings and collected information from 50 Swedish children (7-12 years). Data were analysed concurrently on a descriptive level using statistics and content analysis. Quantitative and qualitative data, including the drawings, were considered equally important and resulted in six categories, illuminating how children accessed and perceived information about the pandemic. RESULTS The survey showed that children accessed information mainly from school but also from TV. They preferred information from reliable sources. Children reported the information they accessed as easy to understand and it prompted them to ask new questions. They reported they knew a lot about the pandemic, for example, the potential danger to themselves and others and how to act to protect themselves and others. They perceived the pandemic as an intrusion on their lives. CONCLUSIONS This study indicates that Swedish children between 7 and 12 years old were well informed about SARS-CoV2 and Covid-19 during the first phase of the pandemic. School was shown to be an important source of information. The children could explain how to act to protect themselves and others from becoming infected by the virus.
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Affiliation(s)
- Lise-Lott Rydström
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden
| | - Charlotte Ångström-Brännström
- Department of Nursing, Umeå University, Sweden
- Department of Women's and Children's Health, Uppsala University, Sweden
| | - Lucy Blake
- Department of Social Science, University of the West of England (UWE)
| | - Lucy Brayl
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Bernie Carter
- Department of Social Science, University of the West of England (UWE)
| | - Maria Forsner
- Department of Nursing, Umeå University, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden
| | - Janet Matsson
- The Swedish Red Cross University College, Department of Health Sciense, Sweden
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Sweden
| | - Stefan Nilsson
- University of Gothenburg Centre for Person-centred Care', University of Gothenburg, Sweden
- University of Gothenburg Sahlgrenska Akademi, Health and Care Sciences and The Queen Silvia Children's Hospital, Sweden
| | - Margaretha Jenholt Nolbris
- University of Gothenburg Centre for Person-centred Care', University of Gothenburg, Sweden
- University of Gothenburg Sahlgrenska Akademi, Health and Care Sciences and The Queen Silvia Children's Hospital, Sweden
| | - Jennifer Kirton
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Sweden
| | | | | | - Holly Saron
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Anna Lindholm Olinder
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Sweden
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99
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Lazzerini M, Covi B, Mariani I, Drglin Z, Arendt M, Nedberg IH, Elden H, Costa R, Drandić D, Radetić J, Otelea MR, Miani C, Brigidi S, Rozée V, Ponikvar BM, Tasch B, Kongslien S, Linden K, Barata C, Kurbanović M, Ružičić J, Batram-Zantvoort S, Castañeda LM, Rochebrochard EDL, Bohinec A, Vik ES, Zaigham M, Santos T, Wandschneider L, Viver AC, Ćerimagić A, Sacks E, Valente EP. Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region. THE LANCET REGIONAL HEALTH. EUROPE 2022; 13:100268. [PMID: 34977838 PMCID: PMC8703114 DOI: 10.1016/j.lanepe.2021.100268] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic, as defined by WHO Standards, are lacking. METHODS Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. FINDINGS 21,027 mothers were included in the analysis. Among those who experienced labour (N=18,063), 41·8% (26·1%- 63·5%) experienced difficulties in accessing antenatal care, 62% (12·6%-99·0%) were not allowed a companion of choice, 31·1% (16·5%-56·9%) received inadequate breastfeeding support, 34·4% (5·2%-64·8%) reported that health workers were not always using protective personal equipment, and 31·8% (17·8%-53·1%) rated the health workers' number as "insufficient". Episiotomy was performed in 20·1% (6·1%-66·0%) of spontaneous vaginal births and fundal pressure applied in 41·2% (11·5% -100%) of instrumental vaginal births. In addition, 23·9% women felt they were not treated with dignity (12·8%-59·8%), 12·5% (7·0%-23·4%) suffered abuse, and 2·4% (0·1%-26·2%) made informal payments. Most findings were significantly worse among women with prelabour caesarean birth (N=2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significant lower QMNC Indexes and Luxemburg showing a significantly higher QMNC Index than the total sample. Younger women and those with operative births also reported significantly lower QMNC Indexes. INTERPRETATION Mothers reports revealed large inequities in QMNC across countries of the WHO European Region. Quality improvement initiatives to reduce these inequities and promote evidence-based, patient-centred respectful care for all mothers and newborns during the COVID-19 pandemic and beyond are urgently needed. FUNDING The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. STUDY REGISTRATION ClinicalTrials.gov Identifier: NCT04847336.
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Affiliation(s)
- Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Zalka Drglin
- National Institute of Public Health, Ljubljana, Slovenia
| | - Maryse Arendt
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
| | | | - Helen Elden
- Institute of Health and Care sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska university hospital, Dept of Obstetrics & Gynecology, Gothenburg, Sweden
| | - Raquel Costa
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Hei-Lab:Digital Human-Environment Interaction Lab. Faculty of Psychology, Education and Sports, Lusófona University, Porto, Portugal
| | | | | | - Marina Ruxandra Otelea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
| | - Céline Miani
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Serena Brigidi
- Department of Anthropology, Philosophy and Social Work. Medical Anthropology Research Center (MARC). Rovira i Virgili University (URV), Tarragona, Spain
| | - Virginie Rozée
- Sexual and Reproductive Health and Rights Research Unit, Institut National d’Études Démographiques (INED), Paris, France
| | | | - Barbara Tasch
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
- Neonatal intensive care unit, KannerKlinik, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Sigrun Kongslien
- Department of health and care sciences, UiT The Arctic University of Norway
| | - Karolina Linden
- Institute of Health and Care sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Catarina Barata
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisboa, Portugal
| | | | | | - Stephanie Batram-Zantvoort
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | | | - Elise de La Rochebrochard
- Sexual and Reproductive Health and Rights Research Unit, Institut National d’Études Démographiques (INED), Paris, France
| | - Anja Bohinec
- National Institute of Public Health, Ljubljana, Slovenia
| | - Eline Skirnisdottir Vik
- Department of health and caring sciences, Western Norway University of Applied Sciences, Norway
| | - Mehreen Zaigham
- Obstetrics & Gynecology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Teresa Santos
- Universidade Europeia, Lisboa, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, Lisbon, Portugal
| | - Lisa Wandschneider
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | | | | | - Emma Sacks
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - IMAgiNE EURO study group
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
- National Institute of Public Health, Ljubljana, Slovenia
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
- Department of community medicine, UiT The Arctic University of Norway
- Institute of Health and Care sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska university hospital, Dept of Obstetrics & Gynecology, Gothenburg, Sweden
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Hei-Lab:Digital Human-Environment Interaction Lab. Faculty of Psychology, Education and Sports, Lusófona University, Porto, Portugal
- Roda – Parents in Action, Zagreb, Croatia
- Centar za mame, Belgrade, Serbia
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
- Department of Anthropology, Philosophy and Social Work. Medical Anthropology Research Center (MARC). Rovira i Virgili University (URV), Tarragona, Spain
- Sexual and Reproductive Health and Rights Research Unit, Institut National d’Études Démographiques (INED), Paris, France
- Neonatal intensive care unit, KannerKlinik, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Department of health and care sciences, UiT The Arctic University of Norway
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisboa, Portugal
- Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
- Institut Català de la Salut, Generalitat de Catalunya, Spain
- Department of health and caring sciences, Western Norway University of Applied Sciences, Norway
- Obstetrics & Gynecology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
- Universidade Europeia, Lisboa, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, Lisbon, Portugal
- Institut Català d'Antropologia (ICA), Barcelona, Spain
- NGO Baby Steps, Sarajevo, Bosnia-Herzegovina
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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100
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Juul FE, Jodal HC, Barua I, Refsum E, Olsvik Ø, Helsingen LM, Løberg M, Bretthauer M, Kalager M, Emilsson L. Mortality in Norway and Sweden during the COVID-19 pandemic. Scand J Public Health 2022; 50:38-45. [PMID: 34609261 PMCID: PMC8807990 DOI: 10.1177/14034948211047137] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/23/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Background: Norway and Sweden are similar countries in terms of socioeconomics and health care. Norway implemented extensive COVID-19 measures, such as school closures and lockdowns, whereas Sweden did not. Aims: To compare mortality in Norway and Sweden, two similar countries with very different mitigation measures against COVID-19. Methods: Using real-world data from national registries, we compared all-cause and COVID-19-related mortality rates with 95% confidence intervals (CI) per 100,000 person-weeks and mortality rate ratios (MRR) comparing the five preceding years (2015-2019) with the pandemic year (2020) in Norway and Sweden. Results: In Norway, all-cause mortality was stable from 2015 to 2019 (mortality rate 14.6-15.1 per 100,000 person-weeks; mean mortality rate 14.9) and was lower in 2020 than from 2015 to 2019 (mortality rate 14.4; MRR 0.97; 95% CI 0.96-0.98). In Sweden, all-cause mortality was stable from 2015 to 2018 (mortality rate 17.0-17.8; mean mortality rate 17.1) and similar to that in 2020 (mortality rate 17.6), but lower in 2019 (mortality rate 16.2). Compared with the years 2015-2019, all-cause mortality in the pandemic year was 3% higher due to the lower rate in 2019 (MRR 1.03; 95% CI 1.02-1.04). Excess mortality was confined to people aged ⩾70 years in Sweden compared with previous years. The COVID-19-associated mortality rates per 100,000 person-weeks during the first wave of the pandemic were 0.3 in Norway and 2.9 in Sweden. Conclusions: All-cause mortality in 2020 decreased in Norway and increased in Sweden compared with previous years. The observed excess deaths in Sweden during the pandemic may, in part, be explained by mortality displacement due to the low all-cause mortality in the previous year.
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Affiliation(s)
- Frederik E. Juul
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Henriette C. Jodal
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Ishita Barua
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Erle Refsum
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Ørjan Olsvik
- Faculty of Health Sciences, The Arctic University of Norway, Norway
| | - Lise M. Helsingen
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Magnus Løberg
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Michael Bretthauer
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Mette Kalager
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
| | - Louise Emilsson
- Clinical Effectiveness Research Group, Oslo University Hospital and University of Oslo, Norway
- Department of General Practice, University of Oslo, Norway
- Vårdcentralen Årjäng & Centre for Clinical Research, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden
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