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Zhang H, Zhang X, Jiang X, Dai R, Zhao N, Pan W, Guo J, Fan J, Bao S. Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial. Trials 2024; 25:299. [PMID: 38698436 DOI: 10.1186/s13063-024-08139-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE To evaluate mindfulness-based intervention for hypertension with depression and/or anxiety. METHODS 10-week mindfulness-based intervention, including health education for hypertension, exclusively for the control group, was administered to the intervention group to assist sixty hypertension patients with depression/anxiety. Among them, the intervention group comprised 8 men and 22 women, with a mean age of 60.02 years and a mean duration of hypertension of 6.29 years. The control group consisted of 14 men and 16 women with a mean age of 57.68 years and a mean duration of hypertension of 6.32 years. The severity of depressive and/or anxiety symptoms was assessed using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7), along with blood pressure (BP) measurements taken twice daily. The study utilized a self-made self-efficacy scale and awareness of physical and mental health to evaluate mental health and state. RESULTS The depression PHQ-9 or GAD-7 scores reduced by 21.1% or 17.8% in the mindfulness-based intervention group, compared to the control (Z = -2.040, P = 0.041) post 10-week period, suggesting significant reduction in anxiety/stress. These results were consistent with a reduction in systolic BP of 12.24 mm Hg (t = 6.041, P = 0.000). The self-efficacy score of the mindfulness intervention group significantly improved compared to the control (t = 7.818, P < 0.001), while the awareness of physical and mental health in the mindfulness intervention group significantly improved compared to the control (χ2 = 5.781, P = 0.016). CONCLUSION Mindfulness-based, short-term focused interventions provide modest relief for depression and/or anxiety and are effective in lowering blood pressure and improving self-efficacy scores. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900028258. Registered 16 December 2019, https://www.chictr.org.cn/showproj.html?proj=43627 .
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Affiliation(s)
- Hailiang Zhang
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China
- Collaborative Innovation Center for Traditional Chinese Medicine Prevention and, Control of Environmental and Nutrition-Related Diseases in Northwest China, Lanzhou, 730101, Gansu, China
- Department of Mental Health, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, 730030, Gansu, China
| | - Xiangrong Zhang
- Department of Chinese Medicine, Center of Hekou Town, Xigu District, Lanzhou, 730094, Gansu, China
| | - Xiaomei Jiang
- Department of Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Xigu District, Lanzhou, 730060, Gansu, China
| | - Runjing Dai
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China
| | - Na Zhao
- Department of Hospital Infection-Control, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, 730020, Gansu, China
| | - Weimin Pan
- Department of Mental Health, Gansu Provincial Centre for Disease Control and Prevention, Lanzhou, 730030, Gansu, China
| | - Jiaohong Guo
- Department of Vasculo-Cardiology, Pingliang Second People's Hospital, Kongtong District, Pingliang, 744000, Gansu, China.
| | - Jingchun Fan
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China.
- Collaborative Innovation Center for Traditional Chinese Medicine Prevention and, Control of Environmental and Nutrition-Related Diseases in Northwest China, Lanzhou, 730101, Gansu, China.
| | - Shisan Bao
- Center for Laboratory and Simulation Training, School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, 730101, Gansu, China.
- Collaborative Innovation Center for Traditional Chinese Medicine Prevention and, Control of Environmental and Nutrition-Related Diseases in Northwest China, Lanzhou, 730101, Gansu, China.
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Zhang X, Yuan L, Tan Z, Wu H, Chen F, Huang J, Wang P, Hambly BD, Bao S, Tao K. CD64 plays a key role in diabetic wound healing. Front Immunol 2024; 15:1322256. [PMID: 38524127 PMCID: PMC10957625 DOI: 10.3389/fimmu.2024.1322256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Wound healing poses a clinical challenge in diabetes mellitus (DM) due to compromised host immunity. CD64, an IgG-binding Fcgr1 receptor, acts as a pro-inflammatory mediator. While its presence has been identified in various inflammatory diseases, its specific role in wound healing, especially in DM, remains unclear. Objectives We aimed to investigate the involvement of CD64 in diabetic wound healing using a DM animal model with CD64 KO mice. Methods First, we compared CD64 expression in chronic skin ulcers from human DM and non-DM skin. Then, we monitored wound healing in a DM mouse model over 10 days, with or without CD64 KO, using macroscopic and microscopic observations, as well as immunohistochemistry. Results CD64 expression was significantly upregulated (1.25-fold) in chronic ulcerative skin from DM patients compared to non-DM individuals. Clinical observations were consistent with animal model findings, showing a significant delay in wound healing, particularly by day 7, in CD64 KO mice compared to WT mice. Additionally, infiltrating CD163+ M2 macrophages in the wounds of DM mice decreased significantly compared to non-DM mice over time. Delayed wound healing in DM CD64 KO mice correlated with the presence of inflammatory mediators. Conclusion CD64 seems to play a crucial role in wound healing, especially in DM conditions, where it is associated with CD163+ M2 macrophage infiltration. These data suggest that CD64 relies on host immunity during the wound healing process. Such data may provide useful information for both basic scientists and clinicians to deal with diabetic chronic wound healing.
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Affiliation(s)
- Xiuqin Zhang
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Liuhong Yuan
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhenyu Tan
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huiyan Wu
- Department of Pathology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Feier Chen
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Junjie Huang
- Department of Pathology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Pengjun Wang
- Department of Pathology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Brett D. Hambly
- Department of Pathology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shisan Bao
- Department of Pathology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kun Tao
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Wang Z, Bao S. The impact of social distancing measures (quarantine) policy on tertiary education and medical consultations in China during the COVID-19 pandemic. Front Public Health 2024; 12:1365805. [PMID: 38504676 PMCID: PMC10948518 DOI: 10.3389/fpubh.2024.1365805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Zhuoer Wang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Shisan Bao
- School of Biomedical Engineering, The University of Sydney, Sydney, NSW, Australia
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Cai P, Wang J, Ye P, Feng X, Yang G, Huang C, Chen X, Hambly BD, Bao S, Liang S. Physical exercise/sports ameliorate the internet addiction from college students during the pandemic of COVID-19 in China. Front Public Health 2023; 11:1310213. [PMID: 38179571 PMCID: PMC10764417 DOI: 10.3389/fpubh.2023.1310213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
The rapid advancement of modern technology has significantly driven progress in various IT-related activities, resulting in a substantial increase in internet penetration rates, particularly among college students. The utilization of the internet has become one of the most essential tools in our modern society. However, internet addiction (IA) has emerged as a serious concern, particularly among college students, adversely affecting academic performance and having significant psychological and psychiatric implications. The aim of the current study was to determine the impact of physical exercise, gender and academic year on IA among college students. In the present study, we investigated internet usage, engagement in sports activities, and academic performance among college students from Western, Middle, and Eastern regions of Chinese universities. It's noteworthy that most of the respondents were freshmen. Our findings indicate that freshmen students were more susceptible to experiencing IA. Approximately 75% of students engaged in leisure sports activities, revealing an inverse correlation between sports activity and IA. This correlation aligns with the level of sports involvement, emphasizing the potential benefits of physical activity in mitigating IA. However, our study did not uncover any correlation between geographic location and the occurrence of IA, nor did it find differences between medical and non-medical students. Furthermore, our study revealed no significant variations in IA among students from different ethnic backgrounds. The underlying mechanism of IA is being currently determined. Our data suggest that physical exercise, gender, and academic year have a significant impact on IA among college students.
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Affiliation(s)
- Peiling Cai
- School of Preclinical Medicine, Chengdu, China
| | - Junren Wang
- School of Preclinical Medicine, Chengdu, China
- Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China
| | - Peng Ye
- School of Preclinical Medicine, Chengdu, China
| | | | | | - Chao Huang
- Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China
| | - Xinwei Chen
- Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China
| | | | | | - Shengxiang Liang
- Health Management Center, Guilin, China
- Guangxi Key Laboratory of Metabolic Reprogramming and Intelligent Medical Engineering for Chronic Diseases, The Second Affiliated Hospital, Guilin Medical University, Guilin, China
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Pakkiyaretnam M, Francis VR, Francis GR, Raheem S, Sanjeev R, Rajavarman R, Ramesh R. Demographic Characteristics and Disease Pattern Among Non-COVID-19 Patients Admitted to Medical Units of a Tertiary Care Hospital in Sri Lanka During Lockdown of the COVID-19 Pandemic: A Comparison During and Before Lockdown. Cureus 2023; 15:e45248. [PMID: 37842446 PMCID: PMC10576610 DOI: 10.7759/cureus.45248] [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] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND The COVID-19 infection was rapidly spreading almost all over the world, and the first case was confirmed on 27th January 2020 by a foreign tourist in Sri Lanka. The first Sri Lankan citizen with COVID-19 was confirmed on 11th March 2020. Soon after the confirmation of the disease, long days of lockdown were imposed in almost all parts of the world, including Sri Lanka, to control the spread of the disease. Objectives: To determine the demographic characteristics such as age, sex, number of patients, and disease pattern among non-COVID-19 patients admitted to the medical units during the lockdown of the COVID-19 pandemic and to compare these characteristics with the data before the lockdown. METHODS This was a cross-sectional analytical study. It was conducted at the Teaching Hospital in Batticaloa, Sri Lanka. All the non-COVID-19 patients admitted to medical wards and intensive care units (ICU) were included in this study. Patients admitted to the medical intensive care unit (MICU) and coronary care unit (CCU) were considered ICU admissions in this study. They were studied over a period of one month during lockdown (11th March 2020 to 10th April 2020) and compared with the patients admitted one month prior to the lockdown (11th February 2020 to 10th March 2020). RESULTS Totally, 2340 non-COVID-19 patients (52.5% males) were admitted before the lockdown, and 1376 non-COVID-19 patients (56.2% males) were admitted during the lockdown. This reduction in admission is statistically significant (p-value is <0.001, df=3715). Patients admitted to the wards before lockdown were 2283 (97.6%) and during lockdown were 1309 (95.1%). ICU admissions were N=57 (2.4%) before lockdown and N=67 (4.9%) during lockdown. The common age distribution before the lockdown showed that 26.4% were 31-50 and 41.5% were 51-70 years. Similarly, during lockdown, the age distribution disclosed that 28.9% were 31-50 years and 42.9% were 51-70 years. The disease pattern demonstrated that before lockdown, the majority of patients were admitted for routine hemodialysis (13.2%), to get an injection (9.9%), ischemic heart disease (8.4%), chronic kidney disease (7.3%), and viral fever, including dengue (7.2%). Likewise, during lockdown, more patients were admitted for routine hemodialysis (10.7%), viral fever, including dengue (9.3%), ischemic heart disease (8.8%), to get an injection (8.5%), and chronic kidney disease (5.9%). Conclusion: There was a significant reduction in the number of non-COVID-19-related admissions during the period of lockdown. However, there was not much difference in the proportion of admissions according to gender, age, and disease pattern before and during lockdown. More number of male patients were admitted than female patients. Most of the admitted patients were under the age group of 51-70 years. The highest number of patients were admitted for routine hemodialysis before and during lockdown. However, a slightly higher number of patients were admitted to the ICU during lockdown. Therefore, strengthening the ICU facilities may be an important preparation to accommodate more patients in the future if a similar kind of emergency lockdown occurs in a pandemic situation. In addition, admissions due to non-communicable diseases (NCD) didn't fall in proportion during the pre-COVID-19 period and the lockdown period. Therefore, the redistribution of healthcare facilities needs to be done wisely to face the challenges caused by the NCDs.
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Affiliation(s)
- Mayurathan Pakkiyaretnam
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- University Medical Unit, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Vaithehi R Francis
- Department of Pathophysiology, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- Microbiology, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - George Rajeevan Francis
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- Cardiology, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Sanooz Raheem
- Department of Clinical Sciences, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
| | - Rajavarthani Sanjeev
- Department of Human Biology, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
| | - Rajeswaran Rajavarman
- Department of Human Biology, Faculty of Health-Care Sciences, Eastern University of Sri Lanka, Batticaloa, LKA
- Emergency Medicine, Teaching Hospital Batticaloa, Batticaloa, LKA
| | - Ramanathan Ramesh
- General Internal Medicine, Teaching Hospital Batticaloa, Batticaloa, LKA
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Cataldo I, Novotny D, Carollo A, Esposito G. Mental Health in the Post-Lockdown Scenario: A Scientometric Investigation of the Main Thematic Trends of Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6310. [PMID: 37444157 PMCID: PMC10341738 DOI: 10.3390/ijerph20136310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
Since the outbreak of COVID-19, researchers and clinicians have published scientific articles on the SARS-CoV-2 virus and its medical, organizational, financial, and psychological implications. However, many effects have been observed in the post-lockdown scenario. In this study, we adopted a scientometric-bibliometric approach to drawing the state of the art regarding the emotional and psychological effects of the pandemic after the lockdown. In Scopus, we found 791 papers that were subsequently analyzed using CiteSpace. The document co-citation analysis (DCA) computation generated a network of eight major clusters, each representing a central area of investigation. Specifically, one major cluster-cluster no. 1-focuses on the long-term effects of the COVID-19 pandemic and individuals' ability to develop adaptive coping mechanisms and resilience. The results allow us to frame the fields covered by researchers more precisely and the areas that still need more investigation.
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Affiliation(s)
- Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
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Cai P, Shi Y, Cui J, Wang J, Ren J, Hambly BD, Bao S, Xu Z. The impact of COVID-19 lockdown on nursing higher education at Chengdu University. PLoS One 2023; 18:e0286290. [PMID: 37327232 PMCID: PMC10275429 DOI: 10.1371/journal.pone.0286290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 05/13/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND To combat/control the COVID-19 pandemic, a complete lockdown was implemented in China for almost 6 months during 2020. PURPOSE To determine the impact of a long-term lockdown on the academic performance of first-year nursing students via mandatory online learning, and to determine the benefits of online teaching. METHODS The recruitment and academic performance of 1st-year nursing students were assessed between 2019 [prior to COVID-19, n = 195, (146 women)] and 2020 [during COVID-19, n = 180 (142 women)]. The independent sample t test or Mann-Whitney test was applied for a comparison between these two groups. RESULTS There was no significant difference in student recruitment between 2019 and 2020. The overall performance of the first-year students improved in the Biochemistry, Immunopathology, Traditional Chinese Medicine Nursing and Combined Nursing courses via mandatory online teaching in 2020 compared with traditional teaching in 2019. CONCLUSION Suspension of in-class learning but continuing education virtually online has occurred without negatively impacting academic performance, thus academic goals are more than achievable in a complete lockdown situation. This study offers firm evidence to forge a path for developments in teaching methods to better incorporate virtual learning and technology in order to adapt to fast-changing environments. However, the psychological/psychiatric and physical impact of the COVID-19 lockdown and the lack of face-to-face interaction on these students remains to be explored.
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Affiliation(s)
- Peiling Cai
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Ya Shi
- Postgraduate Office, Chengdu University, Chengdu, China
| | - Jianing Cui
- Postgraduate Office, Chengdu University, Chengdu, China
| | - Junren Wang
- Postgraduate Office, Chengdu University, Chengdu, China
| | - Juan Ren
- Postgraduate Office, Chengdu University, Chengdu, China
| | - Brett D. Hambly
- Centre for Healthy Futures, Torrens University Australia, Sydney, New South Wales, Australia
| | - Shisan Bao
- School of Preclinical Medicine, Chengdu University, Chengdu, China
- Department of General Practice, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhongqing Xu
- Department of General Practice, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Genç Kavas H, Şengönül A. The Hypothetical Psychological Impact of the COVID-19 Pandemic on Pediatrics and Pediatric Emergency Admissions: Evidence from Autoregressive Distributed Lag Model Method. Eurasian J Med 2023; 55:120-127. [PMID: 37403910 PMCID: PMC10440959 DOI: 10.5152/eurasianjmed.2023.0165] [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: 06/23/2022] [Accepted: 11/03/2022] [Indexed: 07/06/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic and related deaths affected the number of admissions of patients to hospitals. However, no study has been found that examines the short and long-term psychological effects of children or their possible psychiatric admissions to hospitals during the pandemic period. In this context, the study aims to analyze the behaviors of individuals under the age of 18 in their health service utilization during the COVID-19 pandemic period. MATERIALS AND METHOD For the study, whether the pandemic and psychiatry department (PSY) admissions affect the pediatrics department (PD) and pediatric emergency department (PED) admissions of children was investigated. The sample was taken from hospitals in Sivas between 2019 and 2021. Autoregressive dis- tributed lag (ARDL) model is applied. The ARDL is an econometric method that can estimate the existence of the long-term correlations (cointegration) of variables and the short and long-term effects of explanatory variables on the dependent variable. RESULTS In the PED application model, the number of deaths, representing the impact of the pandemic, decreased the number of PED applications, while the number of vaccinations increased. On the other hand, applications to the PSY decreased in the short term, but increased in the long term. In the model of pediatric department admissions, in the long term, the number of new COVID-19 cases has decreased the number of PD admissions, while the number of vaccines has increased. While applications made to PSY in the short term have decreased the applications of PD, they have increased in the long term. As a result, the pandemic decreased both children's department admissions. In addition, admissions to PSY, which had greatly decreased in the short term, increased rapidly in the long term. CONCLUSION Providing psychological support to both children and adolescents and their guardians during and after the pandemic should be included in planning.
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Affiliation(s)
- Hatice Genç Kavas
- Department of Health Tourism Management, Sivas Cumhuriyet University, Social Sciences Institution, Sivas, Turkey
| | - Ahmet Şengönül
- Department of Econometrics, Sivas Cumhuriyet University, Faculty of Economics and Administrative Sciences, Sivas, Turkey
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Garcia-Olive I, Lopez Seguí F, Hernandez Guillamet G, Vidal-Alaball J, Abad J, Rosell A. Impact of the COVID-19 pandemic on diagnosis of respiratory diseases in the Northern Metropolitan Area in Barcelona (Spain). MEDICINA CLINICA (ENGLISH ED.) 2023; 160:392-396. [PMID: 37197392 PMCID: PMC10170319 DOI: 10.1016/j.medcle.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/11/2022] [Indexed: 05/19/2023]
Abstract
Objective The COVID-19 pandemic has had a great effect on the management of chronic diseases, by limiting the access to primary care and to diagnostic procedures, causing a decline in the incidence of most diseases. Our aim was to analyze the impact of the pandemic on primary care new diagnoses of respiratory diseases. Methods Observational retrospective study performed to describe the effect of COVID-19 pandemic on the incidence of respiratory diseases according to primary care codification. Incidence rate ratio between pre-pandemic and pandemic period was calculated. Results We found a decrease in the incidence of respiratory conditions (IRR 0.65) during the pandemic period. When we compared the different groups of diseases according to ICD-10, we found a significant decrease in the number of new cases during the pandemic period, except in the case of pulmonary tuberculosis, abscesses or necrosis of the lungs and other respiratory complications (J95). Instead, we found increases in flu and pneumonia (IRR 2.17) and respiratory interstitial diseases (IRR 1.41). Conclusion There has been a decrease in new diagnosis of most respiratory diseases during the COVID-19 pandemic.
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Affiliation(s)
- Ignasi Garcia-Olive
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc Lopez Seguí
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority, Catalan Institute of Health, Badalona, Barcelona, Spain
- Center for Research in Economy and Health, Pompeu Fabra University, Barcelona, Spain
| | - Guillem Hernandez Guillamet
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority, Catalan Institute of Health, Badalona, Barcelona, Spain
- Center for Research in Economy and Health, Pompeu Fabra University, Barcelona, Spain
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerencia Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Barcelona, Spain
- Unitat de Suport a la Recerca de la Catalunya Central, Fundacio Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Barcelona, Spain
- Faculty of Medicine, University of Vic - Central University of Catalonia, Vic, Barcelona, Spain
| | - Jorge Abad
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Rosell
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Hu Q, Hu Y, Gu Y, Song X, Shen Y, Lu H, Zhang L, Liu P, Wang G, Guo C, Fang K, Wang Q. Impact of the COVID-19 pandemic on acute stroke care: An analysis of the 24-month data from a comprehensive stroke center in Shanghai, China. CNS Neurosci Ther 2023. [PMID: 36890633 DOI: 10.1111/cns.14148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Whether the coronavirus disease-2019 (COVID-19) pandemic is associated with a long-term negative impact on acute stroke care remains uncertain. This study aims to compare the timing of key aspects of stroke codes between patients before and after the COVID-19 pandemic. METHODS This retrospective cohort study was conducted at an academic hospital in Shanghai, China and included all adult patients with acute ischemic stroke hospitalized via the emergency department (ED) stroke pathway during the 24 months since the COVID-19 outbreak (COVID-19: January 1, 2020-December 31, 2021). The comparison cohort included patients with ED stroke pathway visits and hospitalizations during the same period (pre-COVID-19: January 1, 2018-December 31, 2019). We compared critical time points of prehospital and intrahospital acute stroke care between patients during the COVID-19 era and patients during the pre-COVID-19 era using t test, χ2 , and Mann-Whitney U test where appropriate. RESULTS A total of 1194 acute ischemic stroke cases were enrolled, including 606 patients in COVID-19 and 588 patients in pre-COVID-19. During the COVID-19 pandemic, the median onset-to-hospital time was about 108 min longer compared with the same period of pre-COVID-19 (300 vs 192 min, p = 0.01). Accordingly, the median onset-to-needle time was 169 min in COVID-19 and 113 min in pre-COVID-19 (p = 0.0001), and the proportion of patients with onset-to-hospital time within 4.5 h was lower (292/606 [48.2%] vs 328/558 [58.8%], p = 0.0003) during the pandemic period. Furthermore, the median door-to-inpatient admission and door-to-inpatient rehabilitation times increased from 28 to 37 h and from 3 to 4 days (p = 0.014 and 0.0001). CONCLUSIONS During the 24 months of COVID-19, a prolongation of stroke onset to hospital arrival and to intravenous rt-PA administration times were noted. Meanwhile, acute stroke patients needed to stay in the ED for a longer time before hospitalization. Educational system support and process optimization should be pursued in order to acquire timely delivery of stroke care during the pandemic.
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Affiliation(s)
- Qimin Hu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiming Hu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Gu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Song
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yijue Shen
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Lu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Zhang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peifeng Liu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guodong Wang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunni Guo
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kan Fang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiaoshu Wang
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Garcia-Olive I, Lopez Seguí F, Hernandez Guillamet G, Vidal-Alaball J, Abad J, Rosell A. Impact of the COVID-19 pandemic on diagnosis of respiratory diseases in the Northern Metropolitan Area in Barcelona (Spain). Med Clin (Barc) 2023; 160:392-396. [PMID: 36822982 PMCID: PMC9868362 DOI: 10.1016/j.medcli.2022.11.021] [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: 09/23/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has had a great effect on the management of chronic diseases, by limiting the access to primary care and to diagnostic procedures, causing a decline in the incidence of most diseases. Our aim was to analyze the impact of the pandemic on primary care new diagnoses of respiratory diseases. METHODS Observational retrospective study performed to describe the effect of COVID-19 pandemic on the incidence of respiratory diseases according to primary care codification. Incidence rate ratio between pre-pandemic and pandemic period was calculated. RESULTS We found a decrease in the incidence of respiratory conditions (IRR 0.65) during the pandemic period. When we compared the different groups of diseases according to ICD-10, we found a significant decrease in the number of new cases during the pandemic period, except in the case of pulmonary tuberculosis, abscesses or necrosis of the lungs and other respiratory complications (J95). Instead, we found increases in flu and pneumonia (IRR 2.17) and respiratory interstitial diseases (IRR 1.41). CONCLUSION There has been a decrease in new diagnosis of most respiratory diseases during the COVID-19 pandemic.
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Affiliation(s)
- Ignasi Garcia-Olive
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Francesc Lopez Seguí
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority, Catalan Institute of Health, Badalona, Barcelona, Spain,Center for Research in Economy and Health, Pompeu Fabra University, Barcelona, Spain
| | - Guillem Hernandez Guillamet
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority, Catalan Institute of Health, Badalona, Barcelona, Spain,Center for Research in Economy and Health, Pompeu Fabra University, Barcelona, Spain
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerencia Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Barcelona, Spain,Unitat de Suport a la Recerca de la Catalunya Central, Fundacio Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Barcelona, Spain,Faculty of Medicine, University of Vic – Central University of Catalonia, Vic, Barcelona, Spain
| | - Jorge Abad
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain,Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Rosell
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain,Germans Trias i Pujol Research Institute (IGTP), Badalona, Barcelona, Spain,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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12
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Vučak J, Popovic B, Ljubotina A, Vojvodić Ž, Sabljak D, Zavidić T. Changes in consultation mode during different phases of the COVID-19 pandemic in Croatian family medicine: a cross-sectional study. BMJ Open 2023; 13:e066325. [PMID: 36690400 PMCID: PMC9871868 DOI: 10.1136/bmjopen-2022-066325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To describe the changes in the type, length and reasons for consultations in primary healthcare during the COVID-19 pandemic in Croatia. This study aimed to test a hypothesis regarding the increased workload of general practitioners (GPs) by introducing more virtual consultations (VCs). DESIGN The study design was cross-sectional and comprised two phases: retrospective and prospective. The retrospective phase included data from April, May and June of 2019, 2020 and 2021, and the prospective phase included data from 2 weeks in June 2021. Additionally, the number, length and reasons for face-to-face consultations (FTFC), VCs and telephone consultations (TCs) with nurses were collected. SETTING AND PARTICIPANTS Overall, 6 GPs from different regions in Croatia with 10 125 enlisted patients. MAIN OUTCOMES MEASURES The retrospective phase compared data for consultation types obtained from electronic medical records. The prospective phase collected the number, length and reasons for FTFCs, VCs and TCs with nurses. RESULTS FTFCs decreased from 58.1% of the total number of visits in 2019 to 41.2% in 2020, while VC increased from 41.9% in 2019 to 58.8% in 2020. Furthermore, an eightfold increase in email consultations was recorded. The average lengths of an FTFC and TC were 7.13±3.38 and 4.01±2.09 min, respectively; FTFCs were significantly longer than TCs (t=7.038, p<0.0001). There was an increase in the total workload (9.4%) in 2021 compared with 2019. CONCLUSION Croatian GPs faced changes in work organisation along with increased workload during the pandemic. Despite the shortening of time in FTFCs, the workload has increased due to the increase in VCs. An appropriate legal framework should be implemented for this new form of consultation. Future research is needed to address the impact of these changes on healthcare quality.
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Affiliation(s)
- Jasna Vučak
- Katedra obiteljske medicine, Sveučilište u Rijeci, Rijeka, Croatia
| | | | | | - Željko Vojvodić
- Sveučilište Josipa Jurja Strossmayera u Osijeku, Osijek, Osijek-Baranja, Croatia
| | - Diana Sabljak
- Association of Teachers in General Practice/Family Medicine, Zagreb, Croatia
| | - Tina Zavidić
- Katedra obiteljske medicine, Sveučilište u Rijeci, Rijeka, Croatia
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13
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Russell G, Lane R, Neil J, Advocat J, Sturgiss EA, Staunton Smith T, Alexander K, Hattle S, Crabtree BF, Miller WL. At the edge of chaos: a prospective multiple case study in Australian general practices adapting to COVID-19. BMJ Open 2023; 13:e064266. [PMID: 36657761 PMCID: PMC9852738 DOI: 10.1136/bmjopen-2022-064266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The rapid onset and progressive course of the COVID-19 pandemic challenged primary care practices to generate rapid solutions to unique circumstances, creating a natural experiment of effectiveness, resilience, financial stability and governance across primary care models. We aimed to characterise how practices in Melbourne, Australia modified clinical and organisational routines in response to the pandemic in 2020-2021 and identify factors that influenced these changes. DESIGN Prospective, qualitative, participatory case study design using constant comparative data analysis, conducted between April 2020 and February 2021. Participant general practitioner (GP) investigators were involved in study design, recruitment of other participants, data collection and analysis. Data analysis included investigator diaries, structured practice observation, documents and interviews. SETTING The cases were six Melbourne practices of varying size and organisational model. PARTICIPANTS GP investigators approached potential participants. Practice healthcare workers were interviewed by social scientists on three occasions, and provided feedback on presentations of preliminary findings. RESULTS We conducted 58 interviews with 26 practice healthcare workers including practice owners, practice managers, GPs, receptionists and nurses; and six interviews with GP investigators. Data saturation was achieved within each practice and across the sample. The pandemic generated changes to triage, clinical care, infection control and organisational routines, particularly around telehealth. While collaboration and trust increased within several practices, others fragmented, leaving staff isolated and demoralised. Financial and organisational stability, collaborative problem solving, creative leadership and communication (internally and within the broader healthcare sector) were major influences on practice ability to negotiate the pandemic. CONCLUSIONS This study demonstrates the complex influences on primary care practices, and reinforces the strengths of clinician participation in research design, conduct and analysis. Two implications are: telehealth, triage and infection management innovations are likely to continue; the existing payment system provides inadequate support to primary care in a global pandemic.
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Affiliation(s)
- Grant Russell
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Riki Lane
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Jennifer Neil
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Jenny Advocat
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Elizabeth Ann Sturgiss
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Timothy Staunton Smith
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Karyn Alexander
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Simon Hattle
- Department of General Practice, Monash University Faculty of Medicine, Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Benjamin F Crabtree
- Research Division, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - William L Miller
- Department of Family Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
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14
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Neyazi N, Lindan C, Perdes S, Ibrahimi AG, Horemans D, Al Afsoor D. The provision and utilization of essential health services in Afghanistan during COVID-19 pandemic. Front Public Health 2023; 10:1097680. [PMID: 36711388 PMCID: PMC9878336 DOI: 10.3389/fpubh.2022.1097680] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/23/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction The COVID-19 pandemic has disrupted provision of essential health services and overwhelmed even robust health systems worldwide. The Afghanistan health system has suffered both from the pandemic, as well as from political upheaval and regime change. Methods We evaluated essential service delivery using data collected from a cross-sectional survey of health care facilities in Afghanistan based on administration of a World Health Organization standardized assessment of frontline service readiness. A multi-stage sampling scheme was used to identify a representative sample of 92 health facilities (68 clinics and 24 hospitals) providing essential health services in five provinces. Facility managers were asked to report on changes in health service delivery in late 2021 and early 2022 (corresponding to the end of a significant national COVID-19 surge in infections) compared to the same period one year earlier. Results Among health facilities evaluated; 29 were in urban and 63 were in rural settings. Most facilities reported an increase in the provision of outpatient care particularly in maternal and child health services as well as for tuberculosis, chronic respiratory diseases, mental health, and substance abuse; the number of in-patients also increased. In contrast, provision of services for malaria, neglected tropical diseases, and community outreach programs decreased. Nearly all facilities used strategies to maintain services, including targeting high-risk patients, promoting self-care, and redirecting patients to alternative health care sites. Nearly three fourth (70.6%) of facilities provided no training about COVID-19 to staff; only 65.2% referred COVID-19 patients to designated hospitals and 44.6% had safe transportation for these patients. Discussion Increased demand for services during this period was likely due to a backlog in need generated during the preceding COVID-19 surge and the political changes happened a few months earlier to this survey. Facilities used various methods to maintain services, although the decrease in provision of community outreach was concerning. Facilities appeared to be able to maintain essential health services, despite an increase in demand. However, awareness and training of COVID-19 protocols and appropriate and safe referrals need to be improved. In general, these series of surveys are informative and helpful to identify any changes in provision of essential health services and can facilitate recovery of health systems during and after pandemics.
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Affiliation(s)
- Narges Neyazi
- Health System Development Department, World Health Organization, Kabul, Afghanistan,*Correspondence: Narges Neyazi ✉
| | - Christina Lindan
- Department of Epidemiology and Biostatistics, and Institute of Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | | | - Abdul Ghani Ibrahimi
- Health System Development Department, World Health Organization, Kabul, Afghanistan
| | - Dirk Horemans
- Department of Universal Health Coverage, World Health Organization, Geneva, Switzerland
| | - Deena Al Afsoor
- Department of Universal Health Coverage, Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
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15
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Cai P, Ye P, Zhang Y, Dai R, Fan J, Hambly BD, Bao S, Tao K. The outcomes of lockdown in the higher education sector during the COVID-19 pandemic. PLoS One 2023; 18:e0282907. [PMID: 37098014 PMCID: PMC10128953 DOI: 10.1371/journal.pone.0282907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/27/2023] [Indexed: 04/26/2023] Open
Abstract
To control COVID-19 pandemic, complete lockdown was initiated in 2020. We investigated the impact of lockdown on tertiary-level academic performance, by comparing educational outcomes amongst first-year students during second semester of their medical course prior to and during lockdown. Evidence: The demographics, including educational outcomes of the two groups were not significantly different during semester one (prior to the lockdown). The academic performance amongst women was better than men prior to lockdown. However, the scores were improved significantly for both sexes during lockdown in 2020, following the complete online teaching, compared to that in 2019, showing no significant difference between men and women in 2020, for English and Chinese History. There were significant different scores between men and women in lab-based Histology Practice in 2019 (in-person tuition) and 2020 (online digital tuition), although only a significant improvement in women was observed between 2019 and 2020. Implication: the forced change to online delivery of the second semester of the first-year medical program in 2020 due to the COVID-19 pandemic did not result in any decline in assessment outcomes in any of the subjects undertaken. We believe extensive online digital media should continue to be available to students in future.
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Affiliation(s)
- Peiling Cai
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Peng Ye
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Yihao Zhang
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Rui Dai
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Jingchun Fan
- School of Public Health, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Brett D Hambly
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shisan Bao
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kun Tao
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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16
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Neshnash M, Metwally N, Ismail M, Joudeh A, Al-Dahshan A, Sharif AR, Sharief N, Nur M, Selim N. Satisfaction of primary care physicians towards initiation of phone consultations during the COVID-19 pandemic management in Qatar: a cross-sectional study. BMC PRIMARY CARE 2022; 23:44. [PMID: 35279085 PMCID: PMC8917813 DOI: 10.1186/s12875-022-01654-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Objectives
To assess primary care physicians’ satisfaction towards initiation of phone consultation during COVID-19 pandemic management in Qatar and to identify the factors associated with dis/satisfaction.
Design
A cross-sectional web-based survey was conducted from 1 June to 30 July 2020.
Setting
All the available 27 public primary healthcare centers in Qatar at the time of the study.
Participants
Two hundred ninety-four primary care physicians working in the publicly run primary healthcare corporation in Qatar.
Primary outcome measures
Overall satisfaction of primary care physicians with the initiation of phone consultation during the COVID-19 pandemic in Qatar and their satisfaction towards each aspect of this management.
Results
Two hundred thirty-nine primary care physicians participated in the survey with a response rate of 53.1%. Overall, about 45% and 21% of respondents agreed that COVID-19 disease management has highly impacted and very highly impacted their daily practice, respectively. More than half of the physicians (59.9%) indicated being satisfied/highly satisfied with the initiation of telephone consultation service. On the other hand, few physicians were satisfied (14.3%) or highly satisfied (3.4%) with conducting telephone consultations with patients who lack previous electronic medical records. Also, only 20.3% and 3.8% of physicians were satisfied and highly satisfied with the lack of physical examination in telephone consultations, respectively. On bivariate analysis, primary care physicians’ age was significantly associated with the perceived level of impact of COVID-19 management on daily practice (P = 0.03). There was no significant association between participants’ characteristics and the level of satisfaction toward telephone consultations. On the other hand, there was a statistically significant association between physicians’ age (p = 0.048) and gender (p = 0.014) and their level of satisfaction toward communication and support.
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17
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Seidu S, Hambling C, Holmes P, Fernando K, Campbell NS, Davies S, Khunti K. The impact of the COVID pandemic on primary care diabetes services in the UK: A cross-sectional national survey of views of health professionals delivering diabetes care. Prim Care Diabetes 2022; 16:257-263. [PMID: 35033477 PMCID: PMC8754561 DOI: 10.1016/j.pcd.2021.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Healthcare systems worldwide have been adversely affected by the Coronavirus disease 2019 (COVID-19) pandemic. There has been a substantial decrease in admissions for acute medical conditions with longer delays between the onset of the symptoms and hospital treatment compared to the pre-pandemic period. The impact of the COVID pandemic on primary care services is uncertain. AIM Using an online survey, we examined the impact of the COVID pandemic on primary care diabetes services in the UK. METHODS An online survey was developed by the Primary Care Diabetes Society research group and administered to healthcare and allied health professionals delivering diabetes care in the UK from January to May 2021. Descriptive statistics and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. RESULTS Of the 1070 professionals surveyed, 975 (91.1%) completed the questionnaire. Most respondents were nurses or nurse practitioners (59.7%) and doctors (32.9%). The mean age of respondents was 52 years and 79% were female. The majority of respondents felt overloaded with work (71.2%) or emotionally drained at the end of a working day (79.1%) compared with the pre-pandemic period. Being a doctor and worried about infecting a family member with the Coronavirus were each associated with an increased odds of being substantially overworked or emotionally drained: (OR = 2.52; 95% CI, 1.25-5.07) and (OR = 2.05; 95% CI, 1.24-3.39), respectively. The most common consultation method used to provide diabetes care during the pandemic was telephone consultation (92.0%). Overall 79.1% of respondents felt the COVID-19 pandemic had had moderate to significant impact on their practice's ability to provide routine diabetes care; 70.6% of respondents felt the COVID-19 pandemic had had moderate to significant impact on their practice's ability to provide routine health checks or screening for type 2 diabetes and approximately half of respondents (48.3%) reported encountering mental health concerns in people with diabetes. CONCLUSIONS COVID-19 pandemic has had significant impact on the ability of healthcare professionals and their practices to deliver routine diabetes care. Failure to restore primary care provision urgently and safely to at least pre-pandemic levels in a sustainable manner may lead to emotionally drained and overworked workforce in primary care, place additional burden on the already overburdened healthcare system and worse outcomes for patients.
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Affiliation(s)
- Samuel Seidu
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4WP, UK.
| | - Clare Hambling
- Bridge Street Surgery, Bridge Street, Downham Market, Norfolk, PE38 9DH, UK
| | - Patrick Holmes
- St George's Medical Practice, Yarm Road, Middleton St George, Darlington, DL2 1BY, UK
| | - Kevin Fernando
- North Berwick Group Practice, 54 St. Baldred's Road, North Berwick, East Lothian EH39 4PU, UK
| | - Nigel S Campbell
- Lisburn Health Centre, Linenhall Street, Lisburn BT28 1LU, Northen Ireland
| | - Sarah Davies
- Woodlands Medical Centre in Ely, Cardiff CF5 4RG, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4WP, UK
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Yang Y, Le KJ, Liang C, Zheng T, Gu ZC, Lin HW, Zhang JD, Luo HJ. Changes in inpatient admissions before and during COVID-19 outbreak in a large tertiary hospital in Shanghai. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:469. [PMID: 35571407 PMCID: PMC9096364 DOI: 10.21037/atm-22-1594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 11/06/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) outbreak caused a significant strain on healthcare resources and utilization worldwide. However, the impact of COVID-19 outbreak on patient hospitalization was barely known. This study aimed to determine the impact of the outbreak on the pattern of inpatient hospital admissions to help allocate health care resources during a pandemic. Methods This retrospective study included patients who were hospitalized in a tertiary teaching hospital in Shanghai between 1 January and 30 April across the years 2017 to 2020. The number of hospitalizations during the study period from 2017 to 2020 were 30,605, 31,464, 32,812 and 24,163, respectively. Changes in patient volumes and the frequency of the International Classification of Diseases and Related Health Problem Tenth Edition (ICD-10) codes before and after the onset of the COVID-19 outbreak were analyzed and presented as absolute and relative differences with 95% confidence intervals between periods of different years. Results Overall inpatient hospital admissions decreased by 26.35% between January and April 2020, compared to the same period in 2019. The average age of patients in 2020 was higher compared to those from 2017 to 2019. Conversely, the proportions of self-paying patients and non-local patients were significantly lower between January and April 2020 compared to the same period in the previous three years. The top five ICD-10 codes remained common before and during the pandemic. Admissions associated with antineoplastic radiation therapy, chemotherapy, and immunotherapy increased in frequency and proportion by 2020 (difference, 5.6%, 95% CI: 4.4% to 6.8%), and increased proportions were observed for liver and intrahepatic bile duct malignancies (2.18%, 95% CI: 1.15% to 3.21%), cerebral infarction (2.27%, 95% CI: 0.54% to 4.00%), and chronic kidney disease (3.56%, 95% CI: 1.79% to 5.33%). Conclusions There was a significant reduction in the number of inpatients and a marked change in admission diagnoses during the COVID-19 outbreak. Our findings are useful for making informed decisions on hospital management and reallocation of available health care resources during a pandemic.
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Affiliation(s)
- Ya Yang
- Department of Medical Administration, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ke-Jia Le
- Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Liang
- Department of Medical Administration, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Zheng
- Department of Information, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi-Chun Gu
- Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hou-Wen Lin
- Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ji-Dong Zhang
- Department of Medical Administration, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua-Jie Luo
- Department of Medical Administration, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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19
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One-Year Impact of COVID-19 Lockdown-Related Factors on Cardiovascular Risk and Mental Health: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031684. [PMID: 35162707 PMCID: PMC8835147 DOI: 10.3390/ijerph19031684] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/01/2023]
Abstract
Lockdown measures have obvious psychological impacts, which could, in turn, increase cardiovascular risk. We assessed the association between lockdown-related factors and the worsening of cardiovascular risk, incident anxiety and depression during 12 months’ follow-up. During lockdown (April–May 2020), 534 subjects, aged 50–89 years, were included in the PSYCOV-CV study (NCT04397835) and followed for up to 12 months post-lockdown. We found that participants with symptoms of depression during lockdown were more likely to report increased cardiovascular drug treatment (Odds-Ratio (OR) = 5.08 (1.78–14.5), p = 0.002), decreased physical activity (OR = 1.76 (1.10–2.82), p = 0.019) and weight gain (OR = 1.85 (1.08–3.17), p = 0.024) after lockdown. Moreover, changes in sleep patterns (OR = 2.35 (1.13–4.88), p = 0.022) or living in a rural area during lockdown (OR = 1.70 (0.96–3.03, p = 0.069) were associated with higher incident depression, whereas a better relationship with one’s partner during lockdown was associated with less incident depression (OR = 0.56 (0.29–1.08), p = 0.084). Finally, we found that continuing to work during lockdown in a role requiring in-person contact with the public (such as cashiers, nurses or physicians) was associated with more incident anxiety after lockdown (OR = 3.38 (1.12–10.2), p = 0.031). Interestingly, decreased consumption of alcohol during lockdown was associated with less incident anxiety (OR = 0.30 (0.10–0.90), p = 0.032). Our study, conducted in a representative sample of an age group at increased risk of both cardiovascular disease and severe COVID-19, increases the understanding of modifiable factors associated with the health impacts of lockdown measures.
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20
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Alshaali A, Abd ElAziz S, Aljaziri A, Farid T, Sobhy M. Preventive steps implemented on geriatric services in the primary health care centers during COVID-19 pandemic. J Public Health Res 2021; 11. [PMID: 34814652 PMCID: PMC8958438 DOI: 10.4081/jphr.2021.2593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/10/2021] [Indexed: 11/26/2022] Open
Abstract
Background: The emergence of the COVID-19 pandemic has changed the delivery of medical care across the world. The objective of the study is to understand and document the preventive steps implemented on geriatric services in the primary health care centers during COVID-19 pandemic. Design and methods: This is a retrospective study carried on geriatric services utilization (Geriatric Clinic, Osteoporosis Clinic, Memory and Dementia Clinic) in primary health care centers in Dubai Health Authority in 2020. Results: The study showed that the overall in person visits for all geriatric service in 2020 declined by almost 70%. The total number of telephone consultations in geriatric clinics, osteoporosis clinics and memory clinics were 1479, 1149 and 104 respectively. The COVID-19 pandemic had led to a reduction in most of the geriatric services including outpatient clinics, screening and referral. Telephone consultation provided a foundation for delivery of the service. Conclusions: This study reflected the potential for telehealth services to bring benefits and convenience to the geriatric population, even after the end of the pandemic. Significance for public health COVID-19 pandemic has resulted in drastic public health measures in most countries of the world. Researches on the impact of COVID19 on different health specialties including geriatric services will help tailoring public polices and health polices to be more prepared to deal with emergencies such as the one created by the COVID-19 pandemic.
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Affiliation(s)
- Anood Alshaali
- Geriatric medicine section, Primary Health Care Sector, Dubai Health Authority, Dubai.
| | - Soha Abd ElAziz
- Geriatric medicine section, Primary Health Care Sector, Dubai Health Authority, Dubai.
| | - Amal Aljaziri
- Geriatric medicine section, Primary Health Care Sector, Dubai Health Authority, Dubai.
| | - Tamer Farid
- Geriatric medicine section, Primary Health Care Sector, Dubai Health Authority, Dubai.
| | - Mona Sobhy
- Geriatric medicine section, Primary Health Care Sector, Dubai Health Authority, Dubai.
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